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帕博西尼(PD-0332991)治疗 CCND1、2 或 3 扩增的 II 期研究:来自 NCI-MATCH ECOG-ACRIN 试验(EAY131)子方案 Z1B 的结果。

Phase II Study of Palbociclib (PD-0332991) in CCND1, 2, or 3 Amplification: Results from the NCI-MATCH ECOG-ACRIN Trial (EAY131) Subprotocol Z1B.

机构信息

University of Pennsylvania, Philadelphia, Pennsylvania.

Dana Farber Cancer Institute - ECOG-ACRIN Biostatistics Center, Boston, Massachusetts.

出版信息

Clin Cancer Res. 2023 Apr 14;29(8):1477-1483. doi: 10.1158/1078-0432.CCR-22-2150.

Abstract

PURPOSE

Cyclin D/CDK4/6 is critical in controlling the G1 to S checkpoint. CCND, the gene encoding cyclin D, is known to be amplified in a variety of solid tumors. Palbociclib is an oral CDK4/6 inhibitor, approved in advanced breast cancer in combination with endocrine therapy. We explored the efficacy of palbociclib in patients with nonbreast solid tumors containing an amplification in CCND1, 2, or 3.

PATIENTS AND METHODS

Patients with tumors containing a CCND1, 2, or 3 amplification and expression of the retinoblastoma protein were assigned to subprotocol Z1B and received palbociclib 125 mg once daily for 21 days of a 28-day cycle. Tumor response was assessed every two cycles.

RESULTS

Forty patients were assigned to subprotocol Z1B; 4 patients had outside assays identifying the CCND1, 2, or 3 amplification and were not confirmed centrally; 3 were ineligible and 2 were not treated (1 untreated patient was also ineligible), leaving 32 evaluable patients for this analysis. There were no partial responses; 12 patients (37.5%) had stable disease as best response. There were seven deaths on study, all during cycle 1 and attributable to disease progression. Median progression-free survival was 1.8 months. The most common toxicities were leukopenia (n = 21, 55%) and neutropenia (n = 19, 50%); neutropenia was the most common grade 3/4 event (n = 12, 32%).

CONCLUSIONS

Palbociclib was not effective at treating nonbreast solid tumors with a CCND1, 2, or 3 amplification in this cohort. These data do not support further investigation of single-agent palbociclib in tumors with CCND1, 2, or 3 amplification.

摘要

目的

细胞周期蛋白 D/CDK4/6 在控制 G1 期到 S 期检查点方面至关重要。细胞周期蛋白 D 的编码基因 CCND 已知在多种实体瘤中扩增。帕博西尼是一种口服 CDK4/6 抑制剂,已被批准与内分泌治疗联合用于晚期乳腺癌。我们探讨了在含有 CCND1、2 或 3 扩增和视网膜母细胞瘤蛋白表达的非乳腺癌实体瘤患者中使用帕博西尼的疗效。

方法

患有含有 CCND1、2 或 3 扩增和视网膜母细胞瘤蛋白表达的肿瘤的患者被分配到子方案 Z1B,并接受每日一次的帕博西尼 125mg,21 天为一个 28 天周期。每两个周期评估一次肿瘤反应。

结果

40 名患者被分配到子方案 Z1B;4 名患者有外部检测方法识别 CCND1、2 或 3 扩增,但未被中心确认;3 名患者不符合条件,2 名患者未接受治疗(1 名未接受治疗的患者也不符合条件),因此 32 名患者可用于此分析。没有部分缓解;12 名患者(37.5%)作为最佳反应有稳定的疾病。研究期间有 7 例死亡,均发生在第 1 周期,归因于疾病进展。中位无进展生存期为 1.8 个月。最常见的毒性是白细胞减少(n = 21,55%)和中性粒细胞减少(n = 19,50%);中性粒细胞减少是最常见的 3/4 级事件(n = 12,32%)。

结论

在该队列中,帕博西尼对含有 CCND1、2 或 3 扩增的非乳腺癌实体瘤没有疗效。这些数据不支持进一步研究在含有 CCND1、2 或 3 扩增的肿瘤中使用单药帕博西尼。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64b6/10102836/ff41d7d36989/1477fig1.jpg

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