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患者报告的维利帕利联合顺铂和依托泊苷治疗广泛期小细胞肺癌的耐受性:ECOG ACRIN 癌症研究组 E2511 期随机试验的神经毒性和依从性数据。

Patient-reported tolerability of veliparib combined with cisplatin and etoposide for treatment of extensive stage small cell lung cancer: Neurotoxicity and adherence data from the ECOG ACRIN cancer research group E2511 phase II randomized trial.

机构信息

Department of Behavioral Science, Center for Health Equity Transformation, University of Kentucky College of Medicine, Lexington, KY, USA.

Dana-Farber Cancer Institute & ECOG-ACRIN Biostatistics Center, Boston, MA, USA.

出版信息

Cancer Med. 2020 Oct;9(20):7511-7523. doi: 10.1002/cam4.3416. Epub 2020 Aug 28.

Abstract

OBJECTIVES

The ECOG-ACRIN Cancer Research Group trial E2511 recently demonstrated a potential benefit for the addition of veliparib to cisplatin-etoposide (CE) in patients with extensive stage small cell lung cancer (ES-SCLC) in a phase II randomized controlled trial. Secondary trial endpoints included comparison of the incidence and severity of neurotoxicity, hypothesized to be lower in the veliparib arm, and tolerability of the addition of veliparib to CE. Physician-rated and patient-reported neurotoxicity was also compared.

MATERIALS AND METHODS

Patients randomized to veliparib plus CE (n = 64) or placebo plus CE (n = 64) completed the 11-item Functional Assessment of Cancer Therapy Gynecologic Oncology Group Neurotoxicity (questionnaire pre-treatment, end of cycle 4 [ie 3 months after randomization] and 3 months post-treatment [ie 6-months]). Adherence analysis was based on treatment forms.

RESULTS AND CONCLUSION

No significant differences in mean or magnitude of change in neurotoxicity scores were observed between treatment arms at any time point. However, patients in the placebo arm reported worsening neurotoxicity from baseline to 3-months (M difference = -1.5, P = .045), compared to stable neurotoxicity in the veliparib arm (M difference = -0.2, P = .778). Weakness was the most common treatment-emergent (>50%) and moderate to severe (>16%) symptom reported, but did not differ between treatment arms. The proportion of adherence to oral therapy in the overall sample was 75%. Three percent of patients reported clinically significant neurotoxicity that was not captured by physician assessment. Neurotoxicity scores were not different between treatment arms. The addition of veliparib to CE appeared tolerable, though weakness should be monitored. CLINICALTRIALS.

GOV IDENTIFIER

NCT01642251.

摘要

目的

ECOG-ACRIN 癌症研究组的 E2511 试验最近在一项 II 期随机对照试验中表明,在广泛期小细胞肺癌(ES-SCLC)患者中,联合使用维利帕尼和依托泊苷顺铂(CE)治疗具有潜在益处。次要试验终点包括比较神经毒性的发生率和严重程度,假设维利帕尼组较低,以及联合使用维利帕尼和 CE 的耐受性。还比较了医生评估和患者报告的神经毒性。

材料和方法

随机分配至维利帕尼加 CE(n=64)或安慰剂加 CE(n=64)的患者完成了 11 项妇科肿瘤组癌症治疗功能评估神经毒性问卷(治疗前、第 4 周期结束时[即随机分组后 3 个月]和治疗后 3 个月[即 6 个月])。基于治疗形式进行了治疗依从性分析。

结果与结论

在任何时间点,治疗组之间的神经毒性评分的平均值或变化幅度均无显著差异。然而,与维利帕尼组神经毒性稳定相比,安慰剂组患者自基线至 3 个月时报告神经毒性恶化(M 差值=-1.5,P=0.045)。最常见的治疗后出现(>50%)和中重度(>16%)症状是乏力,但在治疗组之间无差异。总体样本中口服治疗的依从率为 75%。3%的患者报告了未被医生评估捕捉到的临床显著神经毒性。治疗组之间的神经毒性评分无差异。维利帕尼联合 CE 治疗似乎是可耐受的,尽管应监测乏力。临床试验。

.gov 标识符:NCT01642251。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0313/7571824/0a882ca6f7f0/CAM4-9-7511-g001.jpg

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