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在临床试验 1 期接受治疗的卵巢癌患者的生存和临床结局。

Survival and clinical outcomes of patients with ovarian cancer who were treated on phase 1 clinical trials.

机构信息

Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, Colorado.

Department of Medical Oncology, University of Colorado School of Medicine, Aurora, Colorado.

出版信息

Cancer. 2020 Oct 1;126(19):4289-4293. doi: 10.1002/cncr.33073. Epub 2020 Jul 22.

Abstract

BACKGROUND

Patients with ovarian cancer who are enrolled on phase 1 trials typically have platinum-resistant and heavily pretreated disease, with a poor prognosis. In the current study, the authors assessed prognostic factors and survival in women with recurrent ovarian cancer who were treated on phase 1 clinical trials.

METHODS

The authors performed a retrospective analysis of patients treated from 2008 through 2018 at the University of Colorado Cancer Center. Patient characteristics and treatment and toxicity-related survival data were assessed. Descriptive statistics and Cox proportional hazards models were used to identify risk factors associated with survival time.

RESULTS

A total of 132 patients were treated on phase 1 clinical trials. Patients had a median age of 59 years (range, 33-88 years) with a median of 5.5 previous chemotherapy lines (range, 1-13 lines). Of the 132 patients, 53 (40%) were treated on multiple phase 1 trials with a median of 1 (range, 0-5) prior phase 1 trial. The overall response rate was 14.7%. The median overall survival was 11.3 months (95% CI, 9.1-13.4 months). Two patients died on trial due to progression of disease whereas no patients died of treatment-related toxicity. Independent risk factors found to be predictive of shorter survival were an elevated cancer antigen 125 (CA 125) level (hazard ratio [HR], 2.8; 95% CI, 1.6-5.2) and albumin <3.5 g/dL (HR, 2.5; 95% CI, 1.65-3.79). A body mass index >25 kg/m was predictive of longer survival (HR, 0.65; 95% CI, 0.44-0.96).

CONCLUSIONS

In the current single-institution series, patients with heavily pretreated ovarian cancer who were treated on phase 1 clinical trials experienced a median overall survival of 11.3 months. When available, phase 1 clinical trials represent a reasonable treatment option for patients with heavily pretreated ovarian cancer with a preserved performance status.

摘要

背景

入组 1 期临床试验的卵巢癌患者通常患有铂类耐药和大量预处理的疾病,预后较差。在本研究中,作者评估了在 1 期临床试验中接受治疗的复发性卵巢癌女性的预后因素和生存情况。

方法

作者对 2008 年至 2018 年在科罗拉多大学癌症中心接受治疗的患者进行了回顾性分析。评估了患者特征、治疗和与毒性相关的生存数据。使用描述性统计和 Cox 比例风险模型来确定与生存时间相关的风险因素。

结果

共有 132 名患者接受了 1 期临床试验治疗。患者的中位年龄为 59 岁(范围,33-88 岁),中位化疗线数为 5.5 条(范围,1-13 条)。在 132 名患者中,有 53 名(40%)接受了多次 1 期临床试验治疗,其中中位数为 1 次(范围,0-5 次)之前的 1 期试验。总的缓解率为 14.7%。中位总生存期为 11.3 个月(95%CI,9.1-13.4 个月)。有 2 名患者因疾病进展而在试验中死亡,而没有患者因治疗相关毒性而死亡。独立的风险因素发现,较短的生存预测因素包括癌抗原 125(CA 125)水平升高(风险比[HR],2.8;95%CI,1.6-5.2)和白蛋白<3.5g/dL(HR,2.5;95%CI,1.65-3.79)。体重指数(BMI)>25kg/m 预测生存时间更长(HR,0.65;95%CI,0.44-0.96)。

结论

在本单机构系列中,接受 1 期临床试验治疗的大量预处理卵巢癌患者的中位总生存期为 11.3 个月。在可行的情况下,1 期临床试验代表了一种合理的治疗选择,适用于具有保留的体能状态的大量预处理卵巢癌患者。

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