Department of Internal Medicine, University of Michigan, Ann Arbor, MI.
American Society of Clinical Oncology, Alexandria, VA.
JCO Precis Oncol. 2024 Jul;8:e2400219. doi: 10.1200/PO.24.00219.
Targeted Agent and Profiling Utilization Registry (TAPUR) 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 soft tissue sarcoma with cyclin-dependent kinase 4 () amplification treated with palbociclib are reported.
Eligible patients had measurable disease, Eastern Cooperative Oncology Group performance status 0 to 2, adequate organ function, and no standard treatment options. The primary end point was disease control (DC), defined as objective response (OR) or stable disease (SD) of at least 16+ weeks duration (SD16+) according to RECIST v1.1. The DC rate was estimated with a 90% CI. Secondary end points included OR, progression-free survival (PFS), overall survival (OS), duration of response, duration of SD, and safety.
Forty-two patients with amplification were enrolled. One patient was not evaluable for efficacy. One patient with partial response and 18 with SD16+ were observed for DC and OR rates of 46% (90% CI, 36 to 100) and 2% (95% CI, <1 to 13), respectively. Median PFS was 16 weeks (95% CI, 9 to 28) and median OS was 69 weeks (95% CI, 31 to 111) for evaluable patients. Twenty patients had at least one grade 3 to 4 adverse event (AE) at least possibly related to palbociclib, including alanine aminotransferase increase, anemia, fatigue, hypophosphatemia, leukopenia, neutropenia, and thrombocytopenia. No serious AEs were reported.
Palbociclib met prespecified criteria to declare a signal of antitumor activity in patients with sarcoma and amplification.
靶向药物和分析利用注册(TAPUR)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中商业上可用的靶向药物抗肿瘤活性的 II 期篮子试验。报道了一组接受帕博西尼治疗的 cyclin-dependent kinase 4 () 扩增的软组织肉瘤患者的结果。
符合条件的患者具有可测量的疾病,东部合作肿瘤学组表现状态 0 至 2,足够的器官功能,且没有标准的治疗选择。主要终点是疾病控制(DC),根据 RECIST v1.1 定义为客观缓解(OR)或稳定疾病(SD)至少 16+周(SD16+)。DC 率用 90%CI 估计。次要终点包括 OR、无进展生存期(PFS)、总生存期(OS)、缓解持续时间、SD 持续时间和安全性。
42 例患者存在扩增。1 例患者疗效不可评估。1 例患者部分缓解,18 例患者 SD16+,观察到 DC 和 OR 率分别为 46%(90%CI,36 至 100)和 2%(95%CI,<1 至 13)。可评估患者的中位 PFS 为 16 周(95%CI,9 至 28),中位 OS 为 69 周(95%CI,31 至 111)。20 例患者至少有 1 例 3 级或 4 级不良事件(AE),至少可能与帕博西尼有关,包括丙氨酸氨基转移酶升高、贫血、疲劳、低磷血症、白细胞减少、中性粒细胞减少和血小板减少。未报告严重 AE。
帕博西尼符合规定标准,宣布在具有肉瘤和扩增的患者中具有抗肿瘤活性的信号。