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尼拉帕利联合度伐利尤单抗治疗铂耐药复发性卵巢癌的 II 期研究(MOONSTONE/GOG-3032)结果。

Niraparib and dostarlimab for the treatment of recurrent platinum-resistant ovarian cancer: results of a Phase II study (MOONSTONE/GOG-3032).

机构信息

Virginia Commonwealth University, Massey Cancer Center, Richmond, VA, USA.

The Ohio State University, James Comprehensive Cancer Center, Columbus, OH, USA.

出版信息

Gynecol Oncol. 2023 Nov;178:161-169. doi: 10.1016/j.ygyno.2023.10.005. Epub 2023 Oct 25.

Abstract

OBJECTIVE

This study assessed the efficacy, safety, and health-related quality of life (HRQoL) of the treatment regimen of dostarlimab, a programmed death-1 inhibitor, combined with niraparib, a poly (ADP-ribose) polymerase inhibitor, in patients with BRCA wild type (BRCAwt) recurrent platinum-resistant ovarian cancer (PROC) who had previously received bevacizumab treatment.

METHODS

This Phase II, open-label, single-arm, multicenter study, conducted in the USA, enrolled patients with recurrent PROC to receive niraparib and dostarlimab until disease progression or unacceptable toxicity (up to 3 years). A preplanned interim futility analysis was performed after the first 41 patients had undergone ≥1 radiographic evaluation (approximately 9 weeks from the first treatment).

RESULTS

The prespecified interim futility criterion was met and the study was therefore terminated. For the 41 patients assessed, the objective response rate (ORR) was 7.3% (95% confidence interval: 1.5-19.9); no patients achieved a complete response, 3 patients (7.3%) achieved a partial response (duration of response; 3.0, 3.8, and 9.2 months, respectively), and 9 patients (22.0%) had stable disease. In total, 39 patients (95.1%) experienced a treatment-related adverse event, but no new safety issues were observed. HRQoL, assessed using FOSI, or Functional Assessment of Cancer Therapy - Ovarian Symptom Index scores, worsened over time compared with baseline scores.

CONCLUSIONS

The study was terminated due to the observed ORR at the interim futility analysis. This highlights a need for effective therapies in treating patients with recurrent BRCAwt PROC.

摘要

目的

本研究评估了程序性死亡-1 抑制剂 dostarlimab 联合聚(ADP-核糖)聚合酶抑制剂尼拉帕利在接受贝伐珠单抗治疗后复发的 BRCA 野生型(BRCAwt)铂耐药卵巢癌(PROC)患者中的疗效、安全性和健康相关生活质量(HRQoL)。

方法

这项在美国进行的 II 期、开放标签、单臂、多中心研究招募了复发 PROC 的患者,接受尼拉帕利和 dostarlimab 治疗,直至疾病进展或不可接受的毒性(最长 3 年)。在首次接受≥1 次影像学评估(首次治疗后约 9 周)的 41 例患者中进行了预先计划的中期无效性分析。

结果

达到了预定的中期无效性标准,因此研究终止。在评估的 41 例患者中,客观缓解率(ORR)为 7.3%(95%置信区间:1.5-19.9);无完全缓解,3 例患者(7.3%)部分缓解(缓解持续时间分别为 3.0、3.8 和 9.2 个月),9 例患者(22.0%)病情稳定。共有 39 例患者(95.1%)发生了与治疗相关的不良事件,但未观察到新的安全性问题。使用 FOSI 或功能性评估癌症治疗卵巢症状指数评分评估 HRQoL ,与基线评分相比,随时间恶化。

结论

由于中期无效性分析时观察到的 ORR,研究提前终止。这凸显了在治疗复发的 BRCAwt PROC 患者时需要有效的治疗方法。

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