瑞戈非尼在复发性胶质母细胞瘤老年患者中的临床活性。

Clinical activity of regorafenib in elderly patients with recurrent glioblastoma.

作者信息

Fasano Morena, Pirozzi Mario, Famiglietti Vincenzo, Facchini Sergio, Caterino Marianna, Caroprese Mara, Barillaro Angela, Di Giovanni Ilaria, Auriemma Annunziata, Ileana Sara Fattoruso Silvia, Somma Teresa, Solari Domenico, Bocchetti Marco, Conson Manuel, Pacelli Roberto, Ciardiello Fortunato, Addeo Raffaele

机构信息

Division of Medical Oncology, Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples 80138, Italy.

Department of Advanced Biomedical Sciences, University Federico II, Naples I-80131, Italy.

出版信息

Mol Clin Oncol. 2023 Jan 10;18(2):9. doi: 10.3892/mco.2023.2605. eCollection 2023 Feb.

Abstract

Glioblastoma multiforme is one of the most frequent and aggressive primary tumors in the central nervous system, representing >60% of all brain tumors in adults. Despite treatment, prognosis remains poor with most if not all patients experiencing disease recurrence and a 2-year survival rate of 27%. At present, no confirmed standard treatment exists for recurrent glioblastoma. Regorafenib is one of the few options available, based on results from the REGOMA trial. In the present study, a real-life retrospective investigation on the role of regorafenib in patients with recurrent glioblastoma (>60 years old) from two main Oncological Units in South Italy (Azienda Ospedaliera Universitaria Luigi Vanvitelli, Naples, Italy and Ospedale Civile San Giovanni di Dio, Frattamaggiore, Naples, Italy), was performed. The primary endpoint was overall survival (OS), whereas progression-free survival (PFS), objective response rate and disease control were secondary endpoints. Survival was then analyzed according to age, isocitrate dehydrogenase (IDH) and methylated methylguanine-DNA-methyltransferase (MGMT) status. A total of 56 patients met the eligibility criteria. The intention to treat population median PFS (mPFS) was 4.1 months and median OS (mOS) was 6.8 months. Age did not appear to have a significant influence on mPFS. mOS in MGMT-methylated patients was improved compared with that of the unmethylated group (7.7 months vs. 5.6 months). Both mOS and mPFS were longer in IDH-mutant patients. The present study was one of the first real life analyses of regorafenib in recurrent glioblastoma. The results were in line with the REGOMA trial. Age did not appear to be a prognostic factor, thus suggesting that treatment choice should not be different in elderly. MGMT methylation appeared to influence OS. To the best of our knowledge, this was the first report of regorafenib activity in older patients and, while the results were statistically significant, these should be confirmed in further studies.

摘要

多形性胶质母细胞瘤是中枢神经系统中最常见且侵袭性最强的原发性肿瘤之一,占成人所有脑肿瘤的60%以上。尽管进行了治疗,但大多数(即便不是全部)患者疾病复发,2年生存率为27%,预后仍然很差。目前,复发性胶质母细胞瘤尚无已确认的标准治疗方法。基于REGOMA试验的结果,瑞戈非尼是少数可用的选择之一。在本研究中,对来自意大利南部两个主要肿瘤科室(意大利那不勒斯路易吉·万维泰利大学医院和意大利那不勒斯弗拉塔马焦雷圣乔瓦尼迪奥市民医院)的复发性胶质母细胞瘤(>60岁)患者中瑞戈非尼的作用进行了一项真实世界回顾性调查。主要终点是总生存期(OS),而无进展生存期(PFS)、客观缓解率和疾病控制是次要终点。然后根据年龄、异柠檬酸脱氢酶(IDH)和甲基化的甲基鸟嘌呤-DNA-甲基转移酶(MGMT)状态分析生存期。共有56例患者符合纳入标准。意向性治疗人群的中位PFS(mPFS)为4.1个月,中位OS(mOS)为6.8个月。年龄似乎对mPFS没有显著影响。MGMT甲基化患者的mOS较未甲基化组有所改善(7.7个月对5.6个月)。IDH突变患者的mOS和mPFS均更长。本研究是对瑞戈非尼治疗复发性胶质母细胞瘤的首批真实世界分析之一。结果与REGOMA试验一致。年龄似乎不是一个预后因素,因此表明老年患者的治疗选择不应有所不同。MGMT甲基化似乎会影响OS。据我们所知,这是关于瑞戈非尼在老年患者中活性的首次报告,虽然结果具有统计学意义,但这些结果应在进一步研究中得到证实。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8cb/9905649/ad3d1a9f808f/mco-18-02-02605-g00.jpg

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