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尼拉帕利联合卡铂和紫杉醇治疗 BRCA 突变的晚期乳腺癌(BROCADE3):一项随机 3 期临床试验的最终总生存结果。

Veliparib with carboplatin and paclitaxel in BRCA-mutated advanced breast cancer (BROCADE3): Final overall survival results from a randomized phase 3 trial.

机构信息

Medical Oncology Department, Institut Curie, 26 rue d'Ulm, 75005, Paris, France; Medical Oncology Department, Centre Eugène Marquis, Av. de la Bataille Flandres-Dunkerque CS 44229, 35000 Rennes, France.

Moffitt Cancer Center, 12920 McKinley Drive, Tampa, FL 33612, USA.

出版信息

Eur J Cancer. 2024 Mar;200:113580. doi: 10.1016/j.ejca.2024.113580. Epub 2024 Jan 28.

DOI:10.1016/j.ejca.2024.113580
PMID:38309017
Abstract

BACKGROUND

In the BROCADE3 study, the addition of veliparib to carboplatin plus paclitaxel resulted in a significant improvement in progression-free survival (PFS) compared with placebo plus carboplatin and paclitaxel, in patients with germline BRCA1 or BRCA2 (BRCA1/2)-mutated, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer. We now report final overall survival (OS) data.

METHODS

BROCADE3 is a randomized phase 3 study that enrolled patients with BRCA1/2-mutated, HER2-negative advanced breast cancer who received ≤ 2 prior lines of chemotherapy for metastatic disease. Patients were randomized 2:1 to carboplatin and paclitaxel, dosed with either veliparib or matching placebo. OS was a secondary endpoint.

RESULTS

In the intention-to-treat population (N = 509), 337 patients were randomized to receive veliparib and 172 to placebo. Median OS was 32.4 months vs 28.2 months (hazard ratio, 0.916; 95% CI, 0.736-1.140; P = .434). The updated safety data for veliparib are consistent with those reported in the primary analysis; the addition of veliparib was generally well tolerated.

CONCLUSIONS

Final OS data indicate that the PFS improvement shown in the primary analysis did not translate into an OS benefit. The long survival times observed in both arms suggest that combination therapy with paclitaxel and carboplatin provides clinical benefit in the population of patients with BRCA1/2-mutated metastatic breast cancer.

摘要

背景

在 BROCADE3 研究中,与安慰剂加卡铂和紫杉醇相比,维利帕尼加卡铂加紫杉醇治疗使胚系 BRCA1 或 BRCA2(BRCA1/2)突变、人表皮生长因子受体 2(HER2)阴性的晚期乳腺癌患者的无进展生存期(PFS)显著改善。现将最终总生存期(OS)数据报告如下。

方法

BROCADE3 是一项随机的 3 期研究,招募了接受过≤2 线转移性疾病化疗的 BRCA1/2 突变、HER2 阴性的晚期乳腺癌患者。患者按照 2:1 的比例随机分为卡铂和紫杉醇组,分别接受维利帕尼或匹配安慰剂治疗。OS 是次要终点。

结果

在意向治疗人群(N=509)中,337 例患者接受维利帕尼治疗,172 例患者接受安慰剂治疗。中位 OS 为 32.4 个月与 28.2 个月(风险比,0.916;95%置信区间,0.736-1.140;P=0.434)。维利帕尼的更新安全性数据与主要分析报告的结果一致;添加维利帕尼通常耐受性良好。

结论

最终 OS 数据表明,主要分析中显示的 PFS 改善并未转化为 OS 获益。两个治疗组均观察到的长生存时间表明,紫杉醇和卡铂联合治疗为 BRCA1/2 突变的转移性乳腺癌患者提供了临床获益。

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