Challapalli Amarnath, Pearson Sylvia, Mitra Anita V, Coe Marc, Thomson Alastair, Elliott Tony, Kirkbride Peter, Pickering Lisa, Kirk Hannah, Foulstone Emily, Evans Heidi, Bravo Alicia, Bahl Amit K
Department of Clinical Oncology, Bristol Cancer Institute, Bristol, UK.
University College London Hospitals NHS Foundation Trust, London, UK.
J Int Med Res. 2019 Oct;47(10):4664-4672. doi: 10.1177/0300060519863546. Epub 2019 Sep 10.
To assess the efficacy and tolerability of cabazitaxel in relapsed penile cancer.
This Phase II single-arm trial was designed to recruit 17 patients with relapsed penile cancer. The primary endpoint was objective (complete + partial) response rate (ORR; Response Evaluation Criteria in Solid Tumours [RECIST] v1.1). Treatment comprised six 21-day cycles of cabazitaxel with restaging after cycles 2 and 4. The planned interim analysis was based upon the premise that if none of the first nine patients achieved ORR, trial would be stopped (α = 0.05, Simon’s 2-stage design).
Nine patients were recruited from four UK centres between December 2014 and August 2016. The median age was 61 (range, 27–73.6) years, and seven patients had metastases. Patients received a median of two chemotherapy cycles (range, 2–5). None of the nine patients achieved ORR and the trial was stopped. Cabazitaxel was well tolerated with no dose reductions or delays. Three patients had grade 3/4 adverse events (anaemia, vomiting, or neutropenic sepsis). The median progression-free and overall survival were 1.3 and 5.6 months, respectively.
The trial did not reach the threshold for further continuation of single-agent cabazitaxel. However, the observed tolerability profile supports its further investigation in combination with other agents to improve patient outcomes.
评估卡巴他赛治疗复发性阴茎癌的疗效和耐受性。
这项II期单臂试验旨在招募17例复发性阴茎癌患者。主要终点为客观(完全缓解+部分缓解)缓解率(ORR;实体瘤疗效评价标准[RECIST]v1.1)。治疗包括六个21天周期的卡巴他赛,在第2和第4周期后重新分期。计划中的中期分析基于这样一个前提,即如果前9名患者中没有一人达到ORR,试验将停止(α=0.05,西蒙两阶段设计)。
2014年12月至2016年8月期间,从英国四个中心招募了9名患者。中位年龄为61岁(范围27-73.6岁),7例患者有转移。患者接受化疗周期的中位数为2个(范围2-5个)。9名患者中无一例达到ORR,试验停止。卡巴他赛耐受性良好,无需降低剂量或延迟给药。3例患者出现3/4级不良事件(贫血、呕吐或中性粒细胞减少性败血症)。中位无进展生存期和总生存期分别为1.3个月和5.6个月。
该试验未达到单药卡巴他赛进一步继续开展的阈值。然而,观察到的耐受性情况支持其与其他药物联合进行进一步研究,以改善患者预后。