Look K Y, Blessing J A, Adelson M D, Morris M, Bookman M A
Division of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, USA.
Am J Clin Oncol. 1996 Feb;19(1):7-9. doi: 10.1097/00000421-199602000-00002.
Patients with recurrent epithelial ovarian carcinoma who progress through a cisplatin-based regimen or recur less than 6 months after discontinuing cisplatin, have limited therapeutic options. The Gynecologic Oncology Group conducted a Phase II trial of merbarone in this patient population.
Twenty-seven patients with recurrent epithelial ovarian carcinoma who had previously received one prior cisplatin-based regimen were scheduled to receive 1000 mg/m2 of merbarone by continuous intravenous infusion through a central line each day for five days every four weeks.
Of the 27 patients entered, one was ineligible because of wrong primary, and two never received the drug, leaving 24 patients evaluable for toxicity. Twenty of 24 were evaluable for response. The regimen was well tolerated with only one episode each of GOG grade 3 leukopenia (4%) or grade 4 granulocytopenia (4%). There was one episode (4%) of GOG grade 3 gastrointestinal toxicity. Prior to increasing the infusate concentration to 4 mg/ml, there was one episode (4%) of altered mental status which, in retrospect, may have been secondary to iatrogenic hyponatremia. There were two partial responses (10%) (95% confidence interval 1.2-31.7%).
Merbarone exhibited minimal activity at this schedule in this pretreated group of patients with epithelial ovarian carcinoma.
复发性上皮性卵巢癌患者若对基于顺铂的治疗方案产生耐药,或在停用顺铂后不到6个月复发,其治疗选择有限。妇科肿瘤学组针对该患者群体开展了一项美巴龙的II期试验。
27例复发性上皮性卵巢癌患者,此前均接受过一种基于顺铂的治疗方案,计划每四周连续五天通过中心静脉导管每天接受1000mg/m²美巴龙静脉输注。
入组的27例患者中,1例因原发疾病错误不符合入组标准,2例未接受药物治疗,剩余24例可评估毒性。24例中有20例可评估疗效。该方案耐受性良好,仅出现1例妇科肿瘤学组3级白细胞减少(4%)或4级粒细胞减少(4%)。出现1例(4%)妇科肿瘤学组3级胃肠道毒性。在将输注液浓度提高至4mg/ml之前,出现1例(4%)精神状态改变,事后回顾可能继发于医源性低钠血症。有2例部分缓解(10%)(95%置信区间1.2 - 31.7%)。
在该预处理的上皮性卵巢癌患者组中,按此方案给药时美巴龙活性极小。