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ASCO 2014:高危头颈部鳞状细胞癌辅助术后拉帕替尼同步放化疗不增加DFS

2014-05-23 佚名 dxy

据报道,分别有多达90%和40%的头颈部鳞状细胞癌存在表皮生长因子受体(EGFR)和ErbB2过度表达。拉帕替尼是一种EGFR 和 ErbB2酪氨酸激酶抑制剂(TKI),用于SCCHN治疗显示出活性。 英国皇家Marsden医院的Jean Bourhis等在ASCO 2014年会上报道了一项相关研究成果,他们发现,头颈部鳞状细胞癌患者存在术后复发的高风险。拉帕替尼加用标准RT/CDDP治疗不增加

据报道,分别有多达90%和40%的头颈部鳞状细胞癌存在表皮生长因子受体(EGFR)和ErbB2过度表达。拉帕替尼是一种EGFR 和 ErbB2酪氨酸激酶抑制剂(TKI),用于SCCHN治疗显示出活性。

英国皇家Marsden医院的Jean Bourhis等在ASCO 2014年会上报道了一项相关研究成果,他们发现,头颈部鳞状细胞癌患者存在术后复发的高风险。拉帕替尼加用标准RT/CDDP治疗不增加DFS。

在该试验中,已接受手术的II-IVA 期SCCHN患者(手术切缘≤5mm和/或包膜外扩散)经随机分组,分别接受安慰剂(P)或拉帕替尼治疗。放疗剂量为66Gy (2Gy每天,每周5天)。在放疗第1、22、和43天分别给予顺铂,剂量为100 mg/m2。在CT-RT之前一周、以及期间给予安慰剂或拉帕替尼单药维持治疗直至12个月。患者根据结节状态、原发性肿瘤位点、地理区域及ErbB1表达予以分层处理。

结果显示,ITT人群有688例患者,拉帕替尼治疗组和安慰剂组分别有346 例患者和342例患者。两组患者预后因素平衡良好。两组间顺铂的中位总剂量、中位剂量及RT持续时间相似。试验揭盲时独立审查委员会(IRC)发现拉帕替尼组和安慰剂组的全因复发/死亡率分别为35%和32%。

调查证实了IRC评估结果。任一预设亚组分析均未见DFS显著差异。拉帕替尼组和安慰剂组的死亡率分别为30%和32%。拉帕替尼组和安慰剂组至少一项不良事件的发生率分别为99%和98%。拉帕替尼组因TKI引起的不良事件更常见:如腹泻、皮疹、呕吐等。拉帕替尼组出现左室射血分数下降等严重不良事件的患者有10(3%)例,安慰剂组有3 (<1%)例。

从本试验结果来看,头颈部鳞状细胞癌患者存在术后复发的高风险。拉帕替尼加用标准RT/CDDP治疗不增加DFS。与历史随机化数据相比,两个治疗组的DFS超过CT-RT的效果。临床试验信息:NCT00424255.

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    2015-02-27 xiaoai5777

    好文章,超赞

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    2014-09-23 quxin068
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    2014-05-25 yzh399
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  7. [GetPortalCommentsPageByObjectIdResponse(id=17153, encodeId=db271e1530f, content=好文章,超赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=132, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=36a81612921, createdName=xiaoai5777, createdTime=Fri Feb 27 23:07:00 CST 2015, time=2015-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1978388, encodeId=8f0319e838882, content=<a href='/topic/show?id=3b90e79787f' target=_blank style='color:#2F92EE;'>#细胞癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77978, encryptionId=3b90e79787f, topicName=细胞癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e457184, createdName=qingting, createdTime=Sun Oct 26 10:28:00 CST 2014, time=2014-10-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1938296, encodeId=f33d193829641, content=<a href='/topic/show?id=1c292818fd' target=_blank style='color:#2F92EE;'>#ASC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2818, encryptionId=1c292818fd, topicName=ASC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Tue Sep 23 01:28:00 CST 2014, time=2014-09-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1287862, encodeId=5eb6128e862dd, content=<a href='/topic/show?id=4d185e31825' target=_blank style='color:#2F92EE;'>#放化疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57318, encryptionId=4d185e31825, topicName=放化疗)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=310e209, createdName=yzh399, createdTime=Sun May 25 09:28:00 CST 2014, time=2014-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1297671, encodeId=6fda129e671f0, content=<a href='/topic/show?id=f999444352f' target=_blank style='color:#2F92EE;'>#头颈部鳞状细胞癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44435, encryptionId=f999444352f, topicName=头颈部鳞状细胞癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Sun May 25 09:28:00 CST 2014, time=2014-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1441530, encodeId=64e41441530bd, content=<a href='/topic/show?id=1b785613921' target=_blank style='color:#2F92EE;'>#拉帕替尼#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56139, encryptionId=1b785613921, topicName=拉帕替尼)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7acb4863797, createdName=ms9474365431325850, createdTime=Sun May 25 09:28:00 CST 2014, time=2014-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1491754, encodeId=2be81491e5414, content=<a href='/topic/show?id=b4f14442346' target=_blank style='color:#2F92EE;'>#头颈部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44423, encryptionId=b4f14442346, topicName=头颈部)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0b2d8903151, createdName=wshxjq, createdTime=Sun May 25 09:28:00 CST 2014, time=2014-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1516662, encodeId=016015166622d, content=<a href='/topic/show?id=a8183896891' target=_blank style='color:#2F92EE;'>#同步放化疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=38968, encryptionId=a8183896891, topicName=同步放化疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c1dd10999249, createdName=12498e0fm81暂无昵称, createdTime=Sun May 25 09:28:00 CST 2014, time=2014-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1589674, encodeId=c25a15896e490, content=<a href='/topic/show?id=124d10065220' target=_blank style='color:#2F92EE;'>#颈部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100652, encryptionId=124d10065220, topicName=颈部)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c46a17776631, createdName=木头人519, createdTime=Sun May 25 09:28:00 CST 2014, time=2014-05-25, status=1, ipAttribution=)]
    2014-05-25 wshxjq
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