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尼妥珠单抗治疗不可切除的上皮源性食管肿瘤

Nimotuzumab in the Treatment of Inoperable Esophageal Tumors of Epithelial Origin.

作者信息

González Fernández Sandra, Amador García Yohan, Boris Porras Lucien Gregoria, Mojena Martínez Liuba, Soler Porro Luis Laureano, Pish Martí Gustavo, Fonseca Chon Liem, Estrada Guerra Yelec, Álvarez Blanco Jorge Manuel, Garabito Perdomo Acralys, Santel Odio Félix Bárbaro, Varona Vázquez Luis Alfonso, Ricardo Serrano Yoel Mario, Chao González Lisette, Avila Albuerne Yisel, Sánchez Valdés Lizet, Viada González Carmen Elena, Ramos Suzarte Mayra, Saumell Nápoles Yaimarelis

机构信息

Conrado Benítez Hospital, Libertadores & P. Martí, CP: 90100, Santiago de Cuba, Cuba.

José Ramón López Tabranes Hospital, Carretera Central Km. 101, CP. 40 100, Matanzas, Cuba.

出版信息

J Oncol. 2022 Sep 1;2022:4128946. doi: 10.1155/2022/4128946. eCollection 2022.

Abstract

BACKGROUND

Nimotuzumab is a humanized monoclonal antibody that targets the epidermal growth factor receptor. It was approved in Cuba for the indication of inoperable malignant tumors of the esophagus of epithelial origin. The purpose of this study was to evaluate the safety, overall and progression-free survival, clinical response, and quality of life, in adult patients with inoperable esophageal tumors of epithelial origin treated with nimotuzumab in a practical context. . The number of patients who developed adverse events was determined, and the frequency, seriousness, causality, and severity of these adverse events were determined. It also determined the median of survival and progression-free survival and rates at 12 and 24 months and the quality of life.

RESULTS

A total of 111 patients were included. The proportion of serious and related AE with the use of nimotuzumab was 1.3%. Most of the related AEs were mild and moderate, and the most frequent AEs were diarrhea, chills, and tremors. New diagnosed patients who received nimotuzumab concurrent with chemotherapy and radiotherapy reached a median OS of 12.2 months (95% CI, 6.9-17.5) and 12- and 24-month survival rates of 51.0% and 17.0%, respectively. Median PFS was 7.8 months (95% CI, 6.2-9.5), and 12- and 24-month PFS rates were 39.3% and 11.2%, respectively. A favorable evolution of the general state of health (=0.03) was obtained from the beginning of treatment until month 12, with a significant reduction in the appearance of nausea (=0.009), insomnia (=0.04), constipation (=0.04), eating difficulties (=0.0006), and choking when swallowing (=0.0001), but increased in dysphagia (=0.02).

CONCLUSIONS

The administration of nimotuzumab was safe in the real-world setting. New diagnosed patients that received nimotuzumab concurrent with chemotherapy and radiotherapy reached a higher overall and progression-free survival and better quality of life than the rest of the patients. Trial registration is RPCEC00000215 (Cuban Registry of Clinical Trials; https://registroclinico.sld.cu/en/home). It is registered prospectively on June 30, 2016.

摘要

背景

尼妥珠单抗是一种靶向表皮生长因子受体的人源化单克隆抗体。它在古巴被批准用于治疗上皮源性不可切除的食管恶性肿瘤。本研究的目的是在实际临床环境中评估尼妥珠单抗治疗上皮源性不可切除食管肿瘤成年患者的安全性、总生存期和无进展生存期、临床反应及生活质量。确定发生不良事件的患者数量,并确定这些不良事件的频率、严重程度、因果关系和严重性。还确定了生存期和无进展生存期的中位数以及12个月和24个月时的生存率和生活质量。

结果

共纳入111例患者。使用尼妥珠单抗时严重且相关的不良事件比例为1.3%。大多数相关不良事件为轻度和中度,最常见的不良事件为腹泻、寒战和震颤。接受尼妥珠单抗联合化疗和放疗的新诊断患者的总生存期中位数为12.2个月(95%可信区间,6.9 - 17.5),12个月和24个月生存率分别为51.0%和17.0%。无进展生存期中位数为7.8个月(95%可信区间,6.2 - 9.5),12个月和24个月无进展生存率分别为39.3%和11.2%。从治疗开始到第12个月,患者总体健康状况有良好改善(=0.03),恶心(=0.009)、失眠(=0.04)、便秘(=0.04)、进食困难(=0.0006)和吞咽时呛噎(=0.0001)的发生率显著降低,但吞咽困难发生率有所增加(=0.02)。

结论

在实际临床环境中,尼妥珠单抗的应用是安全的。接受尼妥珠单抗联合化疗和放疗的新诊断患者比其他患者具有更高的总生存期和无进展生存期以及更好的生活质量。试验注册号为RPCEC00000215(古巴临床试验注册中心;https://registroclinico.sld.cu/en/home)。于2016年6月30日进行前瞻性注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb13/9458364/9a5068891896/JO2022-4128946.001.jpg

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