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帕妥珠单抗联合曲妥珠单抗治疗伴有基因改变的胆道癌患者的效果:来自靶向药物和分析利用登记研究的结果。

Pertuzumab Plus Trastuzumab in Patients With Biliary Tract Cancer With Alterations: Results From the Targeted Agent and Profiling Utilization Registry Study.

机构信息

Inova Schar Cancer Institute, Fairfax, VA.

American Society of Clinical Oncology, Alexandria, VA.

出版信息

J Clin Oncol. 2024 Sep 20;42(27):3228-3237. doi: 10.1200/JCO.23.02078. Epub 2024 May 15.

DOI:10.1200/JCO.23.02078
PMID:38748939
Abstract

PURPOSE

Targeted Agent and Profiling Utilization Registry is a phase II basket trial evaluating the antitumor activity of commercially available targeted agents in patients with advanced cancer and genomic alterations known to be drug targets. Results of a cohort of patients with biliary tract cancer (BTC) with amplification, overexpression, or mutation treated with pertuzumab plus trastuzumab are reported.

METHODS

Eligible patients had advanced BTC, measurable disease (RECIST v1.1), Eastern Cooperative Oncology Group performance status 0-2, adequate organ function, tumors with alterations, and a lack of standard treatment options. Simon's two-stage design was used with a primary end point of disease control (DC), defined as objective response (OR) or stable disease of at least 16+ weeks duration (SD16+) according to RECIST v1.1. Secondary end points included OR, progression-free survival, overall survival, duration of response, duration of stable disease, and safety.

RESULTS

Twenty-nine patients were enrolled from February 2017 to January 2022, and all had advanced BTC with an alteration. One patient was not evaluable for efficacy. One complete response, eight partial responses, and two SD16+ were observed for DC and OR rates of 40% (90% CI, 27 to 100) and 32% (95% CI, 16 to 52), respectively. The null hypothesis of 15% DC rate was rejected ( = .0015). Four patients had at least one grade 3 adverse event (AE) or serious AE at least possibly related to treatment: anemia, diarrhea, infusion-related reaction, and fatigue.

CONCLUSION

Pertuzumab plus trastuzumab met prespecified criteria to declare a signal of activity in patients with BTC and amplification, overexpression, or mutation.

摘要

目的

靶向药物和谱分析利用登记处是一项评估针对已知药物靶点的基因组改变的晚期癌症患者的商业上可用的靶向药物抗肿瘤活性的 II 期篮子试验。报道了一组接受曲妥珠单抗联合帕妥珠单抗治疗的胆道癌(BTC)患者的结果,这些患者存在 扩增、过表达或突变。

方法

符合条件的患者患有晚期 BTC,可测量疾病(RECIST v1.1),东部合作肿瘤学组表现状态 0-2,器官功能良好,肿瘤存在 改变,且缺乏标准治疗方案。采用西蒙两阶段设计,主要终点为疾病控制(DC),根据 RECIST v1.1 定义为客观缓解(OR)或持续时间至少为 16+周的稳定疾病(SD16+)。次要终点包括 OR、无进展生存期、总生存期、缓解持续时间、疾病稳定持续时间和安全性。

结果

2017 年 2 月至 2022 年 1 月共招募了 29 名患者,所有患者均患有晚期 BTC,且均存在 改变。1 名患者的疗效不可评估。观察到 DC 和 OR 的发生率分别为 40%(90%CI,27 至 100)和 32%(95%CI,16 至 52),包括 1 例完全缓解、8 例部分缓解和 2 例 SD16+。15%的 DC 率的零假设被拒绝(=.0015)。4 名患者至少有 1 次 3 级不良事件(AE)或至少可能与治疗相关的严重 AE:贫血、腹泻、输注相关反应和疲劳。

结论

曲妥珠单抗联合帕妥珠单抗满足了在存在 扩增、过表达或突变的 BTC 患者中宣布活性信号的预设标准。

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