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Eur J Cancer:乐伐替尼可显著延长放射性碘难治性分化型甲状腺癌患者的存活期,即使已发生了肺转移!

2021-02-20 Nebula MedSci原创

放射性碘难治性分化型甲状腺癌(RR-DTC)患者发生肺转移可能会恶化总生存(OS)预后。SELECT试验是一项3期研究,Tahara等人在该试验中分析了肺转移对患者存活预后的影响进行了分析。

放射性碘难治性分化型甲状腺癌(RR-DTC)患者发生肺转移可能会恶化总生存(OS)预后。SELECT试验是一项3期研究,Tahara等人在该试验中分析了肺转移对患者存活预后的影响进行了分析。

在该试验中,392位RR-DTC患者被随机(2:1)分至乐伐替尼组(lenvatinib,24 mg/日,n=261)或安慰剂组(n=131)。安慰剂处理的患者病情进展后交叉至乐伐替尼组(开放标签)。根据基线肺转移病灶大小对患者进行分组。

各亚组患者预后

乐伐替尼治疗的患者分布在每个基线肺转移亚组中,共226人:根据肺转移病灶大小划分:≥1.0 cm(n=199)、≥1.5 cm(n=150)、≥2.0 cm(n=94)和<2.0 cm(n=105)。有肺转移的患者各治疗组间的OS没有统计学显著差异(HR 0.76, 95% CI 0.57-1.01;p=0.0549)。

安慰剂组和乐伐替尼组的患者OS

两组肺转移病灶≥1.0 cm的患者的中位OS分别为44.7个月(乐伐替尼组)vs 33.1个月(安慰剂组)(HR 0.63,95% CI 0.47-0.85,p=0.0025)。与安慰剂组相比,采用乐伐替尼治疗的有肺转移(≥1.0 cm、≥1.5 cm、≥2.0 cm和<2.0 cm)的患者的OS均显著延长;转移灶≥2.0 cm亚组的患者的中位OS较其他亚组的短(34.7 vs 44.1-49.2个月)。多变量分析表明,经基础特征校正后,乐伐替尼可明显延长肺转移≥1.0 cm的患者的OS。

综上,乐伐替尼治疗可较安慰剂延长有肺转移≥1.0 cm的RR-DTC患者的生存期。

原始出处:

Makoto Tahara, et al. Impact of lung metastases on overall survival in the phase 3 SELECT study of lenvatinib in patients with radioiodine-refractory differentiated thyroid cancer. European Journal of Cancer. February 19, 2021

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    2021-02-22 freve
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    2021-02-21 健康达人

    #甲状腺癌#如果样本量略大一点的话,就有阳性结果了

    0

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