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NEJM:Selumetinib用于无法手术的I型丛状神经纤维瘤的治疗

2020-03-19 MedSci原创 MedSci原创

Selumetinib对无法手术的I型丛状神经纤维瘤患儿临床有益

对于无法手术的I型丛状神经纤维瘤患者,目前还没有获批的治疗方法。近日研究人员开展II期研究,考察Selumetinib对丛状神经纤维瘤患者的客观反应率。
 
患有I型神经纤维瘤,且症状的不能手术的儿童每天两次口服Selumetinib,剂量为25毫克/平方米表面积,每28天为1个周期。至少每4个周期进行一次磁共振成像和临床结果评估(疼痛、生活质量、畸形和功能)。 研究的主要终点为肿瘤疼痛强度评分,从0(无疼痛)到10(最严重疼痛)。
 
50名儿童参与研究,平均年龄10.2岁。最常见的神经纤维瘤相关症状是畸形(44例)、运动功能障碍(33例)和疼痛(26例)。 截至2019年3月29日,共有35名患者(70%)有确认的部分反应,其中28名患者有持久反应(持续≥1年)。 治疗1年后,儿童报告的肿瘤疼痛强度评分的平均下降为2分,被认为是临床上有意义的改善。此外,在儿童报告和父母报告的日常功能(分别为38%和50%)、总体健康相关生活质量(分别为48%和58%)以及力量(56%的患者)和关节活动度(38%患者)等功能结果中,治疗干预也有临床意义的改善。有5名患者因可能与Selumetinib有关的毒性作用而停止治疗,6名患者有疾病进展。最常见的毒性反应是恶心、呕吐、腹泻、肌酸磷酸激酶水平无症状升高、痤疮样皮疹和甲沟炎。
 
研究认为,Selumetinib对无法手术的I型丛状神经纤维瘤患儿临床有益。
 
原始出处:
 
Andrea M. Gross et al. Selumetinib in Children with Inoperable Plexiform Neurofibromas. N Engl J Med, March 19, 2020.

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    2021-01-01 一闲
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    2020-03-19 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

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