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真实世界证据:在墨西哥晚期肺腺癌患者中,以多西他赛为二线治疗方案时,尼达尼布的多中心疗效和毒性分析

Real-World Evidence: Multicenter Efficacy and Toxicity Analysis of Nintedanib With Docetaxel as Second-Line Treatment in Mexican Patients With Advanced Lung Adenocarcinoma.

作者信息

Rodríguez-Cid Jeronimo Rafael, Campos-Gomez Saul, García-Montes Vanessa, Magallanes-Maciel Manuel, Flores-Mariñelarena Rodrigo Rafael, Fernández-Garibay Valeria Michelle, González-Espinoza Iván Romarico, Ceja-García Juan Paulo, Cázarez-Price Juan Carlos, Martínez-Barrera Luis, Barriguete-Parra Leopoldo, Zuloaga-Fernandez Carlos Jose, Kuri-Exsome Roberto, Suárez-García David, Gonzalez-Villanueva Jorge Ignacio, Flores-Anaya Noé, Acevedo-Delgado Jose Antonio, Astorga-Ramos Alma Magdalena, Gerson-Cwilich Raquel, Villalobos-Prieto Alberto, Rodríguez-Silva Claudia, Noriega-Iriondo Maria Fernanda, Vázquez-Cortés Leticia, Perales-Rodríguez Eusebio, Acosta-Espinoza Alicia, Perez-Lozano Yareni, Capdeville-García Daniel, Alatorre-Alexander Jorge Arturo

机构信息

Department of Oncology, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico.

Department of Oncology, Centro Oncológico Estatal ISSEMYM, State of Mexico, Toluca de Lerdo, Mexico.

出版信息

JCO Glob Oncol. 2020 Mar;6:462-470. doi: 10.1200/JGO.19.00330.

Abstract

PURPOSE

The LUME-Lung 1 study has brought consistent evidence of the effective use of nintedanib in lung adenocarcinoma as a second line of treatment; however, differences among ethnicities have been found in some studies.

METHODS

This was a retrospective review among 21 medical centers of 150 patients with a confirmed diagnosis of lung adenocarcinoma, included in a compassionate use program of nintedanib from March 2014 to September 2015. The current study aimed to analyze the effectiveness of nintedanib in combination with docetaxel in the Mexican population, using progression-free survival rate and the best objective response to treatment by RECIST 1.1 as a surrogate of effectiveness. In addition, we examined the toxicity profile of our study population as a secondary end point.

RESULTS

After exclusion criteria, only 99 patients met the criteria for enrollment in the current study. From the total study population, 53 patients (53.5%) were male and 46 (46.5%) were female, with an average age of 60 years and stage IV as the most prevalent clinical stage at the beginning of the compassionate use program. A total of 48 patients (48.5%) had partial response; 26 (26.3%), stable disease; 4 (4%), complete response; and 16 (16.2%), progression; and 5 (5%) were nonevaluable. We found a median progression-free survival of 5 months (95% CI, 4.3 to 5.7 months). The most common grade 3 or 4 adverse reactions were fatigue (14%) and diarrhea (13%).

CONCLUSION

Nintedanib, as part of a chemotherapy regimen, is an effective option with an acceptable toxicity profile for advanced lung adenocarcinoma after first-line treatment progression.

摘要

目的

LUME-Lung 1研究提供了一致的证据,表明尼达尼布在肺腺癌二线治疗中的有效应用;然而,一些研究发现不同种族之间存在差异。

方法

这是一项对21个医学中心的150例确诊肺腺癌患者进行的回顾性研究,这些患者于2014年3月至2015年9月纳入尼达尼布的同情用药计划。本研究旨在分析尼达尼布联合多西他赛在墨西哥人群中的有效性,采用无进展生存率和根据RECIST 1.1标准得出的最佳客观治疗反应作为有效性的替代指标。此外,我们将研究人群的毒性特征作为次要终点进行了检查。

结果

经过排除标准后,只有99例患者符合本研究的入组标准。在整个研究人群中,53例患者(53.5%)为男性,46例(46.5%)为女性,平均年龄为60岁,在同情用药计划开始时,IV期是最常见的临床分期。共有48例患者(48.5%)出现部分缓解;26例(26.3%)病情稳定;4例(4%)完全缓解;16例(16.2%)病情进展;5例(5%)无法评估。我们发现无进展生存期的中位数为5个月(95%CI,4.3至5.7个月)。最常见的3级或4级不良反应是疲劳(14%)和腹泻(13%)。

结论

尼达尼布作为化疗方案的一部分,对于一线治疗进展后的晚期肺腺癌是一种有效的选择,且毒性特征可接受。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7614/7113104/4d890b61fe90/JGO.19.00330f1.jpg

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