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一项针对局部晚期不可切除 III 期非小细胞肺癌患者的卡铂和 Nab-紫杉醇每两周一次联合放疗的 I/II 期研究。

A Phase I/II Study of Biweekly Carboplatin and Nab-paclitaxel With Concurrent Radiotherapy for Patients With Locally Advanced Unresectable Stage III Non-small-cell Lung Cancer.

机构信息

Department of Respiratory Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.

Department of Respiratory Medicine, Aomori Prefectural Central Hospital, Aomori, Japan.

出版信息

Clin Lung Cancer. 2021 Jan;22(1):42-48. doi: 10.1016/j.cllc.2020.09.016. Epub 2020 Oct 14.

Abstract

BACKGROUND

Concurrent chemoradiotherapy (CCRT) is the standard treatment for patients with locally advanced non-small-cell lung cell cancer (LA-NSCLC). We conducted a phase I/II study of biweekly carboplatin and nab-paclitaxel (nab-PTX) with radiotherapy (RT).

MATERIALS AND METHODS

In the phase I part, patients with inoperable stage IIIA/IIIB NSCLC were treated with carboplatin (area under the time-concentration curve, 4) and nab-PTX (60-100 mg/m) on days 1, 15, and 29. Thoracic RT was administered from day 1 to a total dose of 60 Gy in 30 fractions. In the phase II part, patients were administered carboplatin and nab-PTX on days 1, 15, and 29 at the recommended dose (RD). The primary endpoint of the phase I part was to determine the maximum tolerated dose and the RD. In the phase II part, the primary endpoint was 2-year overall survival (OS) rate, and secondary endpoints were the objective response rate, progression-free survival, OS, and safety profile.

RESULTS

In the phase I part, although maximum tolerated dose was not obtained, the RD was carboplatin (area under the time-concentration curve, 4) and nab-PTX (100 mg/m). Of the evaluable 28 patients, the rate of 2-year OS was 67.8% (95% confidence interval, 49.3%-82.1%). The objective response rate was 96.4%, and the median follow-up time was 33.2 months. The median progression-free survival was 18.2 months (95% confidence interval, 13.1 months to not reached). The most common toxicities of grade 3 or higher were neutropenia (60.5%), anemia (14.2%), thrombocytopenia (7.2%), and pneumonitis (3.6%).

CONCLUSIONS

This study achieved the primary endpoint. Biweekly carboplatin and nab-PTX with concurrent RT was well-tolerated and exerted promising antitumor activity.

摘要

背景

同期放化疗(CCRT)是局部晚期非小细胞肺癌(LA-NSCLC)患者的标准治疗方法。我们进行了一项 II 期研究,评估了卡铂和nab-紫杉醇(nab-PTX)联合放疗(RT)的疗效。

材料与方法

在 I 期部分,无法手术的 IIIA/IIIB 期 NSCLC 患者接受卡铂(AUC4)和 nab-PTX(60-100mg/m)治疗,第 1、15 和 29 天给药。从第 1 天开始给予胸部 RT,总剂量为 60Gy,分 30 次进行。在 II 期部分,推荐剂量(RD)下患者在第 1、15 和 29 天接受卡铂和 nab-PTX 治疗。I 期部分的主要终点是确定最大耐受剂量和 RD。II 期部分的主要终点是 2 年总生存率(OS)率,次要终点是客观缓解率、无进展生存期、OS 和安全性。

结果

在 I 期部分,尽管未达到最大耐受剂量,但 RD 为卡铂(AUC4)和 nab-PTX(100mg/m)。在可评估的 28 例患者中,2 年 OS 率为 67.8%(95%置信区间,49.3%-82.1%)。客观缓解率为 96.4%,中位随访时间为 33.2 个月。中位无进展生存期为 18.2 个月(95%置信区间,13.1 个月至未达到)。最常见的 3 级或以上毒性为中性粒细胞减少(60.5%)、贫血(14.2%)、血小板减少(7.2%)和肺炎(3.6%)。

结论

该研究达到了主要终点。卡铂和 nab-PTX 联合同期 RT 耐受性良好,具有良好的抗肿瘤活性。

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