Luo Cong, Ye Wen-Rui, Zu Xiong-Bin, Chen Min-Feng, Qi Lin, Li Yang-Le, Cai Yi
Department of Urology, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha City, China.
Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha City, China.
Front Med (Lausanne). 2021 Nov 24;8:744050. doi: 10.3389/fmed.2021.744050. eCollection 2021.
To assess the safety and efficacy of low-dose everolimus maintenance therapy for tuberous sclerosis complex-related renal angiomyolipoma (TSC-RAML) patients that had previously undergone standard-dose treatment for a minimum of 6 months. In total, 24 patients with a definitive TSC diagnosis were enrolled from April 2018 - April 2019 at Xiangya Hospital, Central South University. All patients underwent low-dose everolimus maintenance therapy following standard-dose everolimus induction therapy for a minimum of 6 months. Patients additionally underwent TSC1/TSC2 genetic testing, And they were followed-up at 3, 6, 12, 18, and 24 months. The Response Evaluation Criteria in Solid Tumors (RECIST, version 1.1) criteria were used to monitor patient RAML responses, while adverse events (AEs) were assessed as per the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE, version 4.0). < 0.05 was the significance level for all analyses, which were performed using SPSS 19.0. TSC1/TSC2 gene mutations were present in all 24 patients, all of whom achieved a significant reduction in TSC-RAML volume within the initial 6-month induction therapy period, and exhibited volume stabilization during the low-dose maintenance therapy treatment period without any instances of TSC-RAML regrowth. Adverse events (AEs) were significantly less severe and less frequent over the course of maintenance therapy relative to standard therapy. Low-dose everolimus maintenance therapy represents an effective approach to achieving TSC-RAML control following a minimum of 6 months of full-dose induction therapy, and may be associated with decreases in everolimus-related AE frequency and severity.
评估低剂量依维莫司维持治疗对曾接受至少6个月标准剂量治疗的结节性硬化症相关肾血管平滑肌脂肪瘤(TSC-RAML)患者的安全性和疗效。2018年4月至2019年4月,中南大学湘雅医院共纳入24例确诊为TSC的患者。所有患者在接受至少6个月的依维莫司标准剂量诱导治疗后,均接受低剂量依维莫司维持治疗。患者还接受了TSC1/TSC2基因检测,并在3、6、12、18和24个月时进行随访。实体瘤疗效评价标准(RECIST,1.1版)用于监测患者RAML的反应,不良事件(AE)则根据美国国立癌症研究所不良事件通用术语标准(CTCAE,4.0版)进行评估。<0.05为所有分析的显著性水平,分析使用SPSS 19.0进行。所有24例患者均存在TSC1/TSC2基因突变;在最初6个月的诱导治疗期内,所有患者的TSC-RAML体积均显著减小,且在低剂量维持治疗期内体积保持稳定,未出现TSC-RAML再生长的情况。与标准治疗相比,维持治疗期间不良事件(AE)的严重程度和发生频率显著降低。低剂量依维莫司维持治疗是在至少6个月的全剂量诱导治疗后实现TSC-RAML控制的有效方法,且可能与依维莫司相关AE的频率和严重程度降低有关。