Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Creighton University School of Medicine at St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
NRG Oncology, Clinical Trial Development Division, Biostatistics & Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
Gynecol Oncol. 2022 Dec;167(3):423-428. doi: 10.1016/j.ygyno.2022.10.006. Epub 2022 Oct 14.
The primary objective of the study was to estimate the 12-month progression-free survival (PFS) for carboplatin/paclitaxel + temsirolimus in women with newly diagnosed clear cell ovarian cancer (CCOC), compared to historical controls in this patient population.
Patients with Stage III or IV CCOC were treated with Paclitaxel 175 mg/m2 on Day 1, Carboplatin AUC 6 Day 1, and temsirolimus (CCI-779) 25 mg IV Days 1 and 8 every 3 weeks for Cycles 1-6 or disease progression, followed by consolidation therapy with temsirolimus 25 mg Days 1, 8, and 15 every 3 weeks cycles 7-17 or until disease progression.
Ninety patients were accrued to the study: 45 in the US and Korea (US/Korea) and 45 in Japan. Twenty-two percent received ≤6 cycles of therapy while 28% completed all 17 cycles of chemotherapy. Median PFS (OS) was 11 (23) months for US/Korea and 12 (26) months for Japan. In the US, none of suboptimally debulked patients had PFS >12 months, and 49% of optimal patients did, compared to 25% and 59% in Japan. Most common grade 3-4 adverse events were neutropenia, leukopenia, anemia, thrombocytopenia, hypertension, hypertriglyceridemia, and oral mucositis.
The carboplatin/paclitaxel + temsirolimus regimen was well tolerated. In optimally debulked patients, 54% had a PFS >12 months. This regimen did not statistically significantly increase PFS at 12 months compared to historical controls. No statistically significant differences in PFS or OS were observed between US/Korea vs Japan, or Asians vs non-Asians.
本研究的主要目的是评估新诊断为透明细胞卵巢癌(CCOC)的女性患者中,卡铂/紫杉醇+替西罗莫司治疗 12 个月的无进展生存率(PFS),与该患者人群中的历史对照相比。
III 期或 IV 期 CCOC 患者接受紫杉醇 175mg/m2 静脉滴注第 1 天,卡铂 AUC 6 第 1 天,替西罗莫司(CCI-779)25mg 静脉滴注第 1 天和第 8 天,每 3 周为 1 个周期,共 6 个周期,或疾病进展,随后进行替西罗莫司 25mg 巩固治疗,每 3 周静脉滴注 1 天、第 8 天和第 15 天,共 17 个周期,或疾病进展。
该研究共纳入 90 例患者:美国和韩国(US/Korea)45 例,日本 45 例。22%的患者接受了≤6 个周期的治疗,28%的患者完成了所有 17 个周期的化疗。US/Korea 和日本的中位 PFS(OS)分别为 11(23)个月和 12(26)个月。在美国,亚最佳减瘤术患者中无一例 PFS>12 个月,而最佳减瘤术患者中有 49%的患者 PFS>12 个月,而日本则分别为 25%和 59%。最常见的 3-4 级不良事件为中性粒细胞减少症、白细胞减少症、贫血、血小板减少症、高血压、高甘油三酯血症和口腔粘膜炎。
卡铂/紫杉醇+替西罗莫司方案耐受性良好。在最佳减瘤术患者中,54%的患者 PFS>12 个月。与历史对照相比,该方案在 12 个月时并未显著增加 PFS。在美国/韩国与日本之间,或亚洲人与非亚洲人之间,未观察到 PFS 或 OS 有统计学显著差异。