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苏韦西妥单抗、恩沃利单抗和FOLFIRI方案用于微卫星稳定或错配修复功能正常的结直肠癌的疗效与安全性:一项2期研究的初步结果

The efficacy and safety of suvemcitug, envafolimab, and FOLFIRI in microsatellite-stable or mismatch repair-proficient colorectal cancer: preliminary results of a phase 2 study.

作者信息

Liu Ying, Wang Jufeng, Fang Yong, Deng Yanhong, Hu Changlu, Fan Qingxia, Gu Kangsheng, Zhang Yu, Yang Chen, Liu Zhenru, Tian Ji, Sun Xiyang, Sun Shuguang, Cheng Ying

机构信息

Internal Medicine, Jilin Cancer Hospital, Changchun, China.

Gastroenterology Department, Henan Cancer Hospital &, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China.

出版信息

Int J Colorectal Dis. 2025 Jan 21;40(1):20. doi: 10.1007/s00384-025-04806-z.

DOI:10.1007/s00384-025-04806-z
PMID:39836256
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11750940/
Abstract

PURPOSE

This phase II study is designed to evaluate the combination therapy involving suvemcitug and envafolimab with FOLFIRI in microsatellite-stable or mismatch repair-proficient (MSS/pMMR) colorectal cancer (CRC) in the second-line treatment setting.

METHODS

This study is a non-randomized, open-label prospective study comprising multiple cohorts (NCT05148195). Here, we only report the data from the CRC cohort. Participants received envafolimab, suvemcitug, and FOLFIRI until disease progression, unacceptable toxicity, or voluntary withdrawal. The recommended dose (RD) and objective response rate (ORR) by investigator assessment were primary endpoints. Secondary endpoints comprised progression-free survival (PFS) and duration of response (DoR). Disease control rate (DCR), overall survival (OS), and safety were also analyzed.

RESULTS

At the data cutoff, no dose-limiting toxicity event was observed in the safety run-in stage, and 2 mg/kg Q2W was declared as RD for suvemcitug combined with envafolimab and FORFIRI. Among 20 patients, 50.0% and 10.0% had been treated with prior antiangiogenic agents and anti-EGFR agents, respectively. ORR and DCR were 25.0% (95% CI 8.7-49.1%) and 90.0% (95% CI 68.3-98.8%), and DoR was 4.1 months (95% CI 3.02, NE). The median PFS and median OS were 5.6 months (95% CI 4.0-8.3) and not reached (95% CI 8.5, NE) by the time of study closure. Neutrophil count decreased, white blood cell count decreased, and hypertension were the most common grade ≥3 treatment-related adverse events (TRAE).

CONCLUSIONS

The safety profile was manageable and the preliminary anti-tumor efficacy was observed in patients with MSS/pMMR CRC in this study, who had failed prior to one line of therapy.

摘要

目的

本II期研究旨在评估在二线治疗环境中,苏韦单抗和恩瓦利单抗联合FOLFIRI方案用于微卫星稳定或错配修复功能正常(MSS/pMMR)的结直肠癌(CRC)的联合治疗效果。

方法

本研究是一项非随机、开放标签的前瞻性研究,包含多个队列(NCT05148195)。在此,我们仅报告CRC队列的数据。参与者接受恩瓦利单抗、苏韦单抗和FOLFIRI治疗,直至疾病进展、出现不可接受的毒性或自愿退出。由研究者评估的推荐剂量(RD)和客观缓解率(ORR)为主要终点。次要终点包括无进展生存期(PFS)和缓解持续时间(DoR)。还分析了疾病控制率(DCR)、总生存期(OS)和安全性。

结果

在数据截止时,在安全性导入阶段未观察到剂量限制性毒性事件,2mg/kg每2周一次被确定为苏韦单抗联合恩瓦利单抗和FOLFIRI的推荐剂量。在20例患者中,分别有50.0%和10.0%曾接受过抗血管生成药物和抗EGFR药物治疗。ORR和DCR分别为25.0%(95%CI 8.7-49.1%)和90.0%(95%CI 68.3-98.8%),DoR为4.1个月(95%CI 3.02,未达到)。在研究结束时,中位PFS和中位OS分别为5.6个月(95%CI 4.0-8.3)和未达到(95%CI 8.5,未达到)。中性粒细胞计数减少、白细胞计数减少和高血压是最常见的≥3级治疗相关不良事件(TRAE)。

结论

在本研究中,对于一线治疗失败的MSS/pMMR CRC患者,安全性可控且观察到了初步的抗肿瘤疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e04/11750940/87e8e1b03646/384_2025_4806_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e04/11750940/a45626a8319d/384_2025_4806_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e04/11750940/87e8e1b03646/384_2025_4806_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e04/11750940/a45626a8319d/384_2025_4806_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e04/11750940/87e8e1b03646/384_2025_4806_Fig2_HTML.jpg

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