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卡博替尼用于日本晚期肝细胞癌患者:一项多中心II期研究的最终结果

Cabozantinib in Japanese patients with advanced hepatocellular carcinoma: Final results of a multicenter phase II study.

作者信息

Kato Naoya, Kudo Masatoshi, Tsuchiya Kaoru, Hagihara Atsushi, Numata Kazushi, Aikata Hiroshi, Inaba Yoshitaka, Kondo Shunsuke, Motomura Kenta, Okano Naohiro, Ikeda Masafumi, Morimoto Manabu, Kuroda Shingo, Kimura Akiko

机构信息

Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan.

Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan.

出版信息

Hepatol Res. 2023 May;53(5):409-416. doi: 10.1111/hepr.13876. Epub 2023 Jan 23.

Abstract

AIM

Cabozantinib showed a favorable benefit-risk profile in Japanese patients with advanced hepatocellular carcinoma (HCC) in an open-label, phase II study (NCT03586973). This analysis presents cumulative data to final database lock.

METHODS

Patients with previously treated, advanced HCC received cabozantinib 60 mg/day. Progression-free survival (PFS) and tumor response rates in prior-sorafenib and sorafenib-naïve cohorts were assessed by independent radiology committee (IRC) and an investigator. Liver function was evaluated by albumin-bilirubin (ALBI) score.

RESULTS

Median cabozantinib exposure was 5.6 months. In the prior-sorafenib cohort (n = 20), median PFS was 7.4 months per IRC assessment and 5.6 months per investigator assessment. In the sorafenib-naïve cohort (n = 14), median PFS was 3.6 and 4.4 months per IRC and investigator assessment, respectively. Six-month PFS rate per IRC and investigator assessment in the prior-sorafenib cohort was 59.8% and 49.5%, respectively, and in the sorafenib-naïve cohort was 16.7% and 35.7%, respectively. Disease control rate by both IRC and investigator assessment was 85.0% in the prior-sorafenib cohort and 64.3% in the sorafenib-naïve cohort. Median overall survival (Kaplan-Meier estimate) was 19.3 and 9.9 months in the prior-sorafenib and sorafenib-naïve cohort, respectively. Mean ALBI score remained relatively constant in patients able to continue treatment. The most frequent adverse events were palmar-plantar erythrodysesthesia syndrome, diarrhea, hypertension, and decreased appetite. No new safety concerns were identified.

CONCLUSIONS

Cabozantinib showed efficacy and a manageable safety profile in Japanese patients with advanced HCC.

摘要

目的

在一项开放标签的II期研究(NCT03586973)中,卡博替尼在日本晚期肝细胞癌(HCC)患者中显示出良好的获益风险特征。本分析展示了截至最终数据库锁定的累积数据。

方法

既往接受过治疗的晚期HCC患者接受卡博替尼每日60毫克治疗。由独立放射学委员会(IRC)和一名研究者评估既往接受过索拉非尼治疗和未接受过索拉非尼治疗队列的无进展生存期(PFS)和肿瘤反应率。通过白蛋白-胆红素(ALBI)评分评估肝功能。

结果

卡博替尼的中位暴露时间为5.6个月。在既往接受过索拉非尼治疗的队列(n = 20)中,根据IRC评估的中位PFS为7.4个月,根据研究者评估为5.6个月。在未接受过索拉非尼治疗的队列(n = 14)中,根据IRC和研究者评估的中位PFS分别为3.6个月和4.4个月。既往接受过索拉非尼治疗队列中,根据IRC和研究者评估的6个月PFS率分别为59.8%和49.5%,在未接受过索拉非尼治疗队列中分别为16.7%和35.7%。根据IRC和研究者评估,既往接受过索拉非尼治疗队列的疾病控制率为85.0%,未接受过索拉非尼治疗队列的疾病控制率为64.3%。既往接受过索拉非尼治疗和未接受过索拉非尼治疗队列的中位总生存期(Kaplan-Meier估计值)分别为19.3个月和9.9个月。能够继续治疗的患者的平均ALBI评分保持相对稳定。最常见的不良事件为手足红斑感觉异常综合征、腹泻、高血压和食欲减退。未发现新的安全问题。

结论

卡博替尼在日本晚期HCC患者中显示出疗效且安全性可控。

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