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Clin Cancer Res:口服Selinexor治疗复发性胶质母细胞瘤

2021-11-12 Nebula MedSci原创

每周一剂塞利尼索 (selinexor) 可诱导复发性胶质母细胞瘤成人患者获得缓解

塞利尼索 (selinexor) 是一种口服的选择性exportin-1抑制剂(XPO1),是全球首款用于治疗多发性骨髓瘤(MM)的选择性核输出 (SINE) 抑制剂,由美国 Karyopharm Therapeutics 公司创制,对各种实体和血液肿瘤都有效。

本研究评估了 selinexor 单药治疗复发性胶质母细胞瘤的穿透性、安全性和有效性。

招募了76位 Karnofsky 表现状态≥60 分的复发性胶质母细胞瘤成人患者。接受细胞减灭手术的患者术前最多接受三剂 selinexor (A组,n=8, 2次/周)。不接受细胞减灭手术的患者每周接受两剂 50mg/m2(B组,n=24)或60mg(C组,n=14),或每周接受一剂 80mg selinexor(D组, n=30)。主要终点是6个月的无进展生存率(PFS6)。

各组的无进展生存率

术前接受 selinexor 治疗的患者切除肿瘤中 selinexor 的中位浓度为105.4 nM(范围 39.7-291 nM)。在 B组、C组和 D组中,6个月的无进展生存率分别是10%(95%CI 2.79-35.9)、7.7%(11.7-50.6%)和17%(7.78-38.3)。在19位(28%)患者中观察到肿瘤体积可测量的缩小;B组、C组和 D组的总 RANO 反应率分别是8.8%(95% CI 1.0-27.0)、7.7%(0.2-36.0)和10%(2.1-26.5);D组有一位患者获得了完全缓解,两位患者获得了持久的部分缓解。

各组的总生存率

26%(34%)患者发生了严重的副反应(AE),其中一例是致死的(1.3%)。最常见的治疗相关的副反应是疲劳(61%)、恶心(59%)、食欲下降(43%)和血小板减少症(43%);但经过支持对症处理和剂量调整,大部分副反应是可控的。

综上所述,对于复发性胶质母细胞瘤成人患者,每周用 80mg 单剂塞利尼索 (selinexor) 可诱导缓解,提高患者的临床相对无进展生存率,而且副反应可控。

原始出处:

Lassman Andrew B,Wen Patrick Y,van den Bent Martin J et al. A Phase 2 Study of the Efficacy and Safety of Oral Selinexor in Recurrent Glioblastoma.[J] .Clin Cancer Res, 2021, https://doi.org/10.1158/1078-0432.CCR-21-2225

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    2021-12-02 ms5000000396997154

    学习了

    0

  5. 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encodeId=8ed21069e86f5, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=144, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bfa45704292, createdName=ms8000001904586235, createdTime=Sat Nov 13 05:02:29 CST 2021, time=2021-11-13, status=1, ipAttribution=)]
  8. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6EF3hKja8nER8RMzxQdria9eCYFhgLTLsDOeqnvIYdeLDz5eP6EnicLuE5gibiawgno4zUA0jAR7Nbtp2llQ9fs3Mk/0, createdBy=278f1986883, createdName=医鸣惊人, createdTime=Sat Nov 13 17:56:09 CST 2021, time=2021-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1069810, encodeId=af8210698103c, content=沙利铂常见的剂量限制性毒性。重要的是,, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Sat Nov 13 08:55:35 CST 2021, time=2021-11-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1069786, encodeId=8ed21069e86f5, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=144, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bfa45704292, createdName=ms8000001904586235, createdTime=Sat Nov 13 05:02:29 CST 2021, time=2021-11-13, status=1, ipAttribution=)]
    2021-11-13 医鸣惊人

    认真学习了。

    0

  9. 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    2021-11-13 查查佳佳

    沙利铂常见的剂量限制性毒性。重要的是,

    0

  10. 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encodeId=8ed21069e86f5, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=144, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bfa45704292, createdName=ms8000001904586235, createdTime=Sat Nov 13 05:02:29 CST 2021, time=2021-11-13, status=1, ipAttribution=)]
    2021-11-13 ms8000001904586235

    学习了

    0

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在神经肿瘤学治疗反应评估(RANO)标准[1]中,确定对比增强肿瘤体积的程度是监测治疗反应的一个重要标志。现阶段已有多项研究表明,基于深度学习的自动分割(DLAS

Radiology:这一影像学技术,可陪伴胶质母细胞瘤患者共同前进!

胶质母细胞瘤的典型特征是血管内皮生长因子介导的血管生成,因此临床上对该蛋白的靶向治疗产生了极大兴趣。

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