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意大利两个高度专业化中心使用帕唑帕尼治疗子宫平滑肌肉瘤的十年真实病例经验:有效性与安全性

A Ten-Year Real-Life Experience with Pazopanib in Uterine Leyomiosarcoma in Two High-Specialized Centers in Italy: Effectiveness and Safety.

作者信息

Mantiero Mara, Bini Marta, Polignano Maggie, Porcu Luca, Sanfilippo Roberta, Fabbroni Chiara, Parma Gabriella, Lapresa Mariateresa, Calidona Carmelo, Silvestri Cecilia, Franza Andrea, Raspagliesi Francesco, Colombo Nicoletta, Ducceschi Monika

机构信息

Department of Gynecologic Oncology, National Cancer Institute of Milan, Via Venezian 1, 20133 Milan, Italy.

Department of Medical Oncology, National Cancer Institute of Milan, Via Venezian 1, 20133 Milan, Italy.

出版信息

Cancers (Basel). 2023 Dec 30;16(1):192. doi: 10.3390/cancers16010192.

DOI:10.3390/cancers16010192
PMID:38201619
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10777896/
Abstract

BACKGROUND

Uterine leiomyosarcoma (uLMS) is characterized by aggressive behavior associated with a high risk of relapse and mortality. Several therapeutic agents have been employed in the treatment of metastatic disease, with a poor objective response rate. Pazopanib, approved in 2012, is a multi-targeted, orally active small molecule that exerts its effects by inhibiting several tyrosine kinases. To date, poor research on real-life data has been conducted. We aimed to assess the effectiveness and safety of the drug in everyday clinical practice.

METHODS

We present results of multicenter retrospective data on 38 patients with heavily pretreated metastatic uLMS who underwent oral pazopanib during their therapeutic journey.

RESULTS

At a median follow-up of 8.6 months, the disease control rate was 55.2%, with 17% partial responses and 15 patients (39.5%) with stable disease. At a median follow-up of 8.6 months, median progression-free survival was 4 months, and median overall survival was 19.8 months. The most common grade 3 adverse events (AEs) drug-related were hepatic toxicities, diarrhea, hypertension, nausea, and vomiting (all of them with an incidence of 5% considering the whole study cohort). No grade 4 AEs occurred.

CONCLUSIONS

Pazopanib in everyday clinical practice is safe and shows a good disease control rate with prolonged survival.

摘要

背景

子宫平滑肌肉瘤(uLMS)具有侵袭性,复发和死亡风险高。几种治疗药物已用于转移性疾病的治疗,但客观缓解率较低。帕唑帕尼于2012年获批,是一种多靶点、口服有效的小分子药物,通过抑制多种酪氨酸激酶发挥作用。迄今为止,对真实世界数据的研究较少。我们旨在评估该药物在日常临床实践中的有效性和安全性。

方法

我们展示了38例接受过大量治疗的转移性uLMS患者在治疗过程中口服帕唑帕尼的多中心回顾性数据结果。

结果

中位随访8.6个月时,疾病控制率为55.2%,其中部分缓解率为17%,15例患者(39.5%)病情稳定。中位随访8.6个月时,无进展生存期为4个月,总生存期为19.8个月。最常见的3级药物相关不良事件是肝毒性、腹泻、高血压、恶心和呕吐(考虑整个研究队列,所有这些不良事件的发生率均为5%)。未发生4级不良事件。

结论

在日常临床实践中,帕唑帕尼是安全的,并且显示出良好的疾病控制率和延长的生存期。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22fc/10777896/1b883f31508c/cancers-16-00192-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22fc/10777896/1f34407151f1/cancers-16-00192-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22fc/10777896/1b883f31508c/cancers-16-00192-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22fc/10777896/1f34407151f1/cancers-16-00192-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22fc/10777896/1b883f31508c/cancers-16-00192-g002.jpg

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本文引用的文献

1
Targeting the Molecular and Immunologic Features of Leiomyosarcoma.针对平滑肌肉瘤的分子和免疫特征
Cancers (Basel). 2023 Mar 31;15(7):2099. doi: 10.3390/cancers15072099.
2
Status of the Current Treatment Options and Potential Future Targets in Uterine Leiomyosarcoma: A Review.子宫平滑肌肉瘤当前治疗方案的现状及潜在的未来靶点:综述
Cancers (Basel). 2022 Feb 24;14(5):1180. doi: 10.3390/cancers14051180.
3
New Insights into Hormonal Therapies in Uterine Sarcomas.子宫肉瘤激素治疗的新见解
Cancers (Basel). 2022 Feb 12;14(4):921. doi: 10.3390/cancers14040921.
4
Italian consensus conference on management of uterine sarcomas on behalf of S.I.G.O. (Societa' italiana di Ginecologia E Ostetricia).代表意大利妇科与产科学会(S.I.G.O.)召开的子宫肉瘤管理意大利共识会议
Eur J Cancer. 2020 Nov;139:149-168. doi: 10.1016/j.ejca.2020.08.016. Epub 2020 Sep 29.
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Efficacy of Pazopanib in patients with metastatic uterine sarcoma: A multi-institutional study.帕唑帕尼治疗转移性子宫肉瘤患者的疗效:一项多机构研究。
J BUON. 2019 Nov-Dec;24(6):2327-2332.
6
Safety and efficacy of Pazopanib in advanced soft tissue sarcoma: PALETTE (EORTC 62072) subgroup analyses.帕唑帕尼治疗晚期软组织肉瘤的安全性和疗效:PALETTE(EORTC 62072)亚组分析。
BMC Cancer. 2019 Aug 13;19(1):794. doi: 10.1186/s12885-019-5988-3.
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Pazopanib in advanced soft tissue sarcomas.帕唑帕尼治疗晚期软组织肉瘤。
Signal Transduct Target Ther. 2019 May 17;4:16. doi: 10.1038/s41392-019-0049-6. eCollection 2019.
8
Uterine leiomyosarcoma: A review of the literature and update on management options.子宫平滑肌肉瘤:文献回顾与治疗选择的更新。
Gynecol Oncol. 2018 Dec;151(3):562-572. doi: 10.1016/j.ygyno.2018.09.010. Epub 2018 Sep 21.
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Drug review: Pazopanib.药物综述:帕唑帕尼
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Systemic treatment in adult uterine sarcomas.成人子宫肉瘤的系统治疗。
Crit Rev Oncol Hematol. 2018 Feb;122:10-20. doi: 10.1016/j.critrevonc.2017.12.009. Epub 2017 Dec 14.