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哌柏西利用于伴有改变的胰腺癌和胆管癌患者:靶向药物与分析利用登记研究结果

Palbociclib in Patients With Pancreatic and Biliary Cancer With Alterations: Results From the Targeted Agent and Profiling Utilization Registry Study.

作者信息

Al Baghdadi Tareq, Halabi Susan, Garrett-Mayer Elizabeth, Mangat Pam K, Ahn Eugene R, Sahai Vaibhav, Alvarez Ricardo H, Kim Edward S, Yost Kathleen J, Rygiel Andrew Lawrence, Antonelli Kaitlyn R, Butler Nicole L, Bruinooge Suanna S, Schilsky Richard L

机构信息

Michigan Cancer Research Consortium, Ypsilanti, MI.

Duke University Medical Center, Durham, NC.

出版信息

JCO Precis Oncol. 2019 Dec;3:1-8. doi: 10.1200/PO.19.00124.

Abstract

PURPOSE

The Targeted Agent and Profiling Utilization Registry (TAPUR) Study identifies signals of antitumor activity of commercially available targeted agents in patients with advanced cancers that harbor genomic alterations known as drug targets. In this article, data from two cohorts of patients with pancreatic and biliary cancers with loss or mutation treated with palbociclib are reported.

METHODS

Eligible patients age 12 years and older with advanced measurable or evaluable solid tumors are provided treatment according to protocol-specified genomic matching rules. The primary study end point is objective response or stable disease of at least 16 weeks duration. For each cohort, a Simon two-stage design was used with a futility evaluation after 10 patients. Secondary end points include safety, progression-free survival (PFS), and overall survival (OS).

RESULTS

Between July 2016 and November 2017, 12 and 10 patients with pancreatic and biliary cancer, respectively, with loss or mutation were treated with palbociclib. Twenty evaluable patients (10 per cohort) were included in the analysis. No patients had objective response or stable disease at 16 weeks, and both cohorts were closed. Two patients, neither with response, were determined to be ineligible. All patients were evaluated for safety, PFS, and OS. A median PFS of 7.2 weeks (90% CI, 4.0 to 8.0 weeks) and median OS of 12.4 weeks (90% CI, 4.7 to 23.1 weeks) were observed in the pancreatic cohort. A median PFS of 7.3 weeks (90% CI, 3.9 to 7.9 weeks) and median OS of 11.1 weeks (90% CI, 5.1 to 14.0 weeks) were observed in the biliary cohort. No unexpected toxicities were observed.

CONCLUSION

Palbociclib monotherapy does not have clinical activity in patients with advanced pancreatic or biliary cancers with loss or mutation. Toxicity is similar to reported experience with palbociclib in other tumor types.

摘要

目的

靶向药物与分析利用登记(TAPUR)研究旨在确定市售靶向药物在患有携带已知为药物靶点的基因组改变的晚期癌症患者中的抗肿瘤活性信号。本文报告了两个队列中接受哌柏西利治疗的伴有缺失或突变的胰腺癌和胆管癌患者的数据。

方法

符合条件的12岁及以上患有晚期可测量或可评估实体瘤的患者按照方案指定的基因组匹配规则接受治疗。主要研究终点是持续至少16周的客观缓解或疾病稳定。对于每个队列,采用西蒙两阶段设计,在10例患者后进行无效性评估。次要终点包括安全性、无进展生存期(PFS)和总生存期(OS)。

结果

2016年7月至2017年11月期间,分别有12例和10例伴有缺失或突变的胰腺癌和胆管癌患者接受了哌柏西利治疗。分析纳入了20例可评估患者(每个队列10例)。16周时无患者出现客观缓解或疾病稳定,两个队列均终止。两名患者均无缓解,被判定为不符合条件。所有患者均接受了安全性、PFS和OS评估。胰腺癌队列中观察到的中位PFS为7.2周(90%CI,4.0至8.0周),中位OS为12.4周(90%CI,4.7至23.1周)。胆管癌队列中观察到的中位PFS为7.3周(90%CI,3.9至7.9周),中位OS为11.1周(90%CI,5.1至14.0周)。未观察到意外毒性。

结论

哌柏西利单药治疗对伴有缺失或突变的晚期胰腺癌或胆管癌患者无临床活性。毒性与哌柏西利在其他肿瘤类型中的报道经验相似。

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