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一项评估索凡替尼治疗不可切除或转移性胆道癌患者的单臂、多中心、开放标签的 2 期临床试验。

A single-arm, multicenter, open-label phase 2 trial of surufatinib in patients with unresectable or metastatic biliary tract cancer.

机构信息

Department of Gastrointestinal Oncology, The Fifth Medical Center, General Hospital of the People's Liberation Army, Beijing, China.

Department of Oncology, The Affiliated Tumor Hospital of Harbin Medical University, Harbin, China.

出版信息

Cancer. 2021 Nov 1;127(21):3975-3984. doi: 10.1002/cncr.33803. Epub 2021 Aug 6.

Abstract

BACKGROUND

Several clinical studies of vascular endothelial growth factor/vascular endothelial growth factor receptor (VEGF/VEGFR) therapy as a second-line treatment for biliary tract cancer (BTC) have shown modest efficacy. In this study, surufatinib was evaluated as a second-line VEGFR therapy in patients with BTC.

METHODS

This was a single-arm, multicenter, open-label phase 2 study conducted in China. The study enrolled eligible patients with BTC, who had received surufatinib monotherapy as second-line treatment, at a dose of 300 mg, once daily, in 28-day cycles. Tumor assessments were performed every 8 weeks (±7 days) according to the Response Evaluation Criteria in Solid Tumors version 1.1.

RESULTS

As of November 30, 2018, 39 patients with BTC, including 29 (74.4%) with intrahepatic cholangiocarcinoma, 5 (12.8%) with extrahepatic cholangiocarcinoma, and 5 (12.8%) with gallbladder cancer, were enrolled and treated with surufatinib. The 16-week progression-free survival rate was 46.33% (95% CI, 24.38-65.73), with median progression-free survival of 3.7 months and median overall survival of 6.9 months. In addition, results from subgroup and post hoc analyses revealed that patients with the proper tumor locations or appropriate levels of serum biomarkers might receive greater clinical benefits. The top 3 treatment-related adverse events with severity of grade ≥3 included blood bilirubin increased (20.5%), hypertension (17.9%), and proteinuria (12.8%).

CONCLUSIONS

When applied in the treatment of patients with BTC, surufatinib monotherapy has offered moderate clinical efficacy and shown expected tolerability and safety profiles.

摘要

背景

几项血管内皮生长因子/血管内皮生长因子受体(VEGF/VEGFR)治疗作为二线治疗胆道癌(BTC)的临床研究显示出适度的疗效。在这项研究中,索凡替尼被评估为 BTC 患者的二线 VEGFR 治疗药物。

方法

这是一项在中国进行的单臂、多中心、开放标签的 2 期研究。该研究纳入了符合条件的 BTC 患者,他们接受了索凡替尼单药二线治疗,剂量为 300mg,每日一次,每 28 天为一个周期。根据实体瘤反应评价标准 1.1,每 8 周(±7 天)进行一次肿瘤评估。

结果

截至 2018 年 11 月 30 日,39 例 BTC 患者入组并接受索凡替尼治疗,包括 29 例(74.4%)肝内胆管癌、5 例(12.8%)肝外胆管癌和 5 例(12.8%)胆囊癌。16 周无进展生存率为 46.33%(95%CI,24.38-65.73),中位无进展生存期为 3.7 个月,中位总生存期为 6.9 个月。此外,亚组和事后分析的结果表明,具有适当肿瘤部位或适当血清生物标志物水平的患者可能会获得更大的临床获益。严重程度≥3 级的前 3 种与治疗相关的不良事件包括胆红素升高(20.5%)、高血压(17.9%)和蛋白尿(12.8%)。

结论

索凡替尼单药治疗 BTC 患者具有中度的临床疗效,并表现出预期的耐受性和安全性特征。

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