リンバチニブとセトキシマブの1期1b試験
Lara A Dunn1, Alan L Ho1, Loren S Michel1
1Head and Neck Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Oral oncology
|September 3, 2025
まとめ
レンバチニブとセトキシマブの組み合わせは,再発性/転移性頭頸部状細胞癌 (HNSCC) の治療に有望な効果を示しています. この研究では,HNSCC患者で顕著な客観的応答率 (ORR) を有する最大許容量 (MTD) が特定されました.
科学分野:
- 腫瘍学
- 医学 研究
- 臨床試験
背景:
- 皮質成長因子受容体 (EGFR) の過剰発現は,頭頸部状細胞癌 (HNSCC) で一般的です.
- セトキシマブ単独治療は,再発性/転移性 (R/ M) HNSCCにおいて限られた効果を示します.
- レンバチニブは多標的受容体チロシンキナーゼ阻害剤で,EGFR阻害に対する抵抗に関与するFGFRを標的とする.
研究 の 目的:
- R/ M HNSCC患者におけるレンバチニブとセトキシマブの併用の安全性と有効性を評価する.
- 標準的なセトゥキシマブ投与で最大許容量 (MTD) を決定する.
主な方法:
- 標準的なセトキシマブ投与と併用したレンバチニブ (三つの用量レベル) の投与量減少を含む1段階1bの単一施設試験.
- MTDを決定するために3 + 3の設計が使用されました.
- 拡張段階では,客観的な応答率 (ORR) と中位進行性生存率 (mPFS) のような探索的エンドポイントを評価するために,MTDに追加されたHNSCC患者さんを登録しました.
主要な成果:
- レンバチニブのMTDは1日20mgと決定された.
- 拡張段階では,MTDを受けた10人の評価可能なHNSCC患者は70%のORR (7/ 10の部分応答) を示した.
- 高血圧および口腔粘膜炎を含む関連グレード3の有害事象で,進行しない生存期間 (mPFS) の中位値は4. 1ヶ月でした.
結論:
- レンバチニブ (毎日20mg) とセトゥキシマブを併用すると,R/ M HNSCCにおける予備的な効果が示されています.
- 観察されたORRは,この組み合わせがHNSCC治療の臨床試験におけるさらなる調査を正当化することを示唆しています.
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