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对 mobocertinib(TAK-788)治疗exon20 插入阳性非小细胞肺癌观察到的不良事件的特征和管理。

Characterization and management of adverse events observed with mobocertinib (TAK-788) treatment for exon 20 insertion-positive non-small cell lung cancer.

机构信息

Graduate Institute of Oncology, National Taiwan University Hospital and National Taiwan University Cancer Center, Taipei, Taiwan.

Shanghai Pulmonary Hospital, Shanghai, China.

出版信息

Expert Rev Anticancer Ther. 2023 Jan;23(1):95-106. doi: 10.1080/14737140.2023.2157815. Epub 2022 Dec 28.

Abstract

BACKGROUND

Mobocertinib has demonstrated durable clinical benefit in platinum-pretreated patients (PPP) with epidermal growth factor receptor exon 20 insertion-positive non-small cell lung cancer (NSCLC).

RESEARCH DESIGN AND METHODS

Pooled safety analysis of two studies included patients with NSCLC (N = 257) treated with the recommended phase 2 dose (RP2D) of mobocertinib (160 mg once daily). We report overall safety (treatment-emergent adverse events [TEAEs]) in the RP2D population; characterization of GI and skin-related events in 114 PPP from a phase 1/2 study (NCT02716116); and clinical activity in PPP with and without dose reductions due to TEAEs.

RESULTS

In the RP2D population (N = 257), the most common TEAEs were diarrhea (93%), nausea (47%), rash (38%), and vomiting (37%). In PPP (N = 114), median times to diarrhea onset and resolution were 5 and 2 days, respectively. Median times to onset and resolution of skin-related events were 9 and 78 days, respectively. Among PPP with (n = 29) or without (n = 85) dose reductions due to TEAEs, overall response rates were 21% and 31% and median durations of response were 5.7 and 17.5 months, respectively.

CONCLUSIONS

GI and skin-related events are common with mobocertinib; minimizing dose reductions with proactive management may improve clinical outcomes.

TRIAL REGISTRATION

NCT02716116; NCT03807778.

摘要

背景

Mobocertinib 在铂类预处理的表皮生长因子受体外显子 20 插入阳性非小细胞肺癌 (NSCLC) 患者中显示出持久的临床获益。

研究设计和方法

两项研究的汇总安全性分析纳入了接受推荐的 2 期剂量 (RP2D) mobocertinib(每日一次 160mg)治疗的 NSCLC 患者(N=257)。我们报告了 RP2D 人群的总体安全性(治疗中出现的不良事件 [TEAEs]);一项 1/2 期研究(NCT02716116)中 114 名 PPP 的 GI 和皮肤相关事件特征;以及因 TEAEs 而减少剂量的 PPP 的临床活性。

结果

在 RP2D 人群(N=257)中,最常见的 TEAEs 是腹泻(93%)、恶心(47%)、皮疹(38%)和呕吐(37%)。在 PPP 中(N=114),腹泻发作和缓解的中位时间分别为 5 天和 2 天。皮肤相关事件的中位发病和缓解时间分别为 9 天和 78 天。在因 TEAEs 而减少剂量的 PPP 中(n=29)或未减少剂量的 PPP 中(n=85),总缓解率分别为 21%和 31%,缓解持续时间中位数分别为 5.7 个月和 17.5 个月。

结论

Mobocertinib 常见的胃肠道和皮肤相关事件;通过积极管理尽量减少剂量减少可能会改善临床结果。

试验注册

NCT02716116;NCT03807778。

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