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阿帕替尼联合依托泊苷治疗晚期三阴性乳腺癌预处理患者:一项 II 期临床试验。

Apatinib plus etoposide in pretreated patients with advanced triple-negative breast cancer: a phase II trial.

机构信息

The Fourth Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China.

The First Ward of the Oncology Department, The First Affilliated Hospital of Harbin Medical University, Harbin, China.

出版信息

BMC Cancer. 2023 May 19;23(1):463. doi: 10.1186/s12885-023-10768-8.

Abstract

BACKGROUND

Treatment options for pretreated triple-negative breast cancer (TNBC) are limited. This study aimed to evaluate the efficacy and safety of apatinib, an antiangiogenic agent, in combination of etoposide for pretreated patients with advanced TNBC.

METHODS

In this single-arm phase II trial, patients with advanced TNBC who failed to at least one line of chemotherapy were enrolled. Eligible patients received oral apatinib 500 mg on day 1 to 21, plus oral etoposide 50 mg on day 1 to 14 of a 3-week cycle until disease progression or intolerable toxicities. Etoposide was administered up to six cycles. The primary endpoint was progression-free survival (PFS).

RESULTS

From September 2018 to September 2021, 40 patients with advanced TNBC were enrolled. All patients received previous chemotherapy in the advanced setting, with the median previous lines of 2 (1-5). At the cut-off date on January 10, 2022, the median follow-up was 26.8 (1.6-52.0) months. The median PFS was 6.0 (95% confidence interval [CI]: 3.8-8.2) months, and the median overall survival was 24.5 (95%CI: 10.2-38.8) months. The objective response rate and disease control rate was 10.0% and 62.5%, respectively. The most common adverse events (AEs) were hypertension (65.0%), nausea (47.5%) and vomiting (42.5%). Four patients developed grade 3 AE, including two with hypertension and two with proteinuria.

CONCLUSIONS

Apatinib combined with oral etoposide was feasible in pretreated advanced TNBC, and was easy to administer.

CLINICAL TRIAL REGISTRATION

Chictr.org.cn, (registration number: ChiCTR1800018497, registration date: 20/09/2018).

摘要

背景

预处理的三阴性乳腺癌(TNBC)的治疗选择有限。本研究旨在评估抗血管生成药物阿帕替尼联合依托泊苷在预处理的晚期 TNBC 患者中的疗效和安全性。

方法

在这项单臂 II 期试验中,招募了至少接受过一线化疗失败的晚期 TNBC 患者。符合条件的患者接受口服阿帕替尼 500mg,第 1 天至第 21 天,加上口服依托泊苷 50mg,第 1 天至第 14 天,每 3 周为一个周期,直至疾病进展或无法耐受毒性。依托泊苷最多给予 6 个周期。主要终点是无进展生存期(PFS)。

结果

从 2018 年 9 月至 2021 年 9 月,共招募了 40 名晚期 TNBC 患者。所有患者均在晚期接受了既往化疗,中位数为 2 线(1-5 线)。截至 2022 年 1 月 10 日截止日期,中位随访时间为 26.8(1.6-52.0)个月。中位 PFS 为 6.0(95%置信区间[CI]:3.8-8.2)个月,中位总生存期为 24.5(95%CI:10.2-38.8)个月。客观缓解率和疾病控制率分别为 10.0%和 62.5%。最常见的不良反应(AE)为高血压(65.0%)、恶心(47.5%)和呕吐(42.5%)。4 名患者发生 3 级 AE,其中 2 名高血压,2 名蛋白尿。

结论

阿帕替尼联合口服依托泊苷在预处理的晚期 TNBC 中是可行的,且易于管理。

临床试验注册

Chictr.org.cn(注册号:ChiCTR1800018497,注册日期:20/09/2018)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1921/10199533/2ffed39968b2/12885_2023_10768_Fig1_HTML.jpg

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