在未经治疗的晚期黑色素瘤中使用Bempegaldesleukin加Nivolumab:开放标签,III期PIVOT IO 001试验结果
Adi Diab1, Helen Gogas2, Shahneen Sandhu3
1Melanoma Medical Oncology Department, The University of Texas MD Anderson Cancer Center, Houston, TX.
概括
与单独使用NIVO相比,Bempegaldesleukin (BEMPEG) 加上nivolumab (NIVO) 并没有改善第一线转移性黑色素瘤的结果. 在PIVOT IO 001试验中,组合治疗显示出毒性增加,但未达到初级疗效终点.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 黑色素瘤治疗方法
背景情况:
- 不切除或转移性黑色素瘤需要新的治疗策略.
- 贝佩加尔德斯莱金 (BEMPEG) 是一种基化互乐金-2 (IL-2) 细胞因子前药物,在之前的II期试验中显示出有前途.
- 基于之前的发现,第三期PIVOT IO 001研究评估了BEMPEG与nivolumab (NIVO) 结合用于一线黑色素瘤治疗.
研究的目的:
- 评估BEMPEG加NIVO与NIVO单一治疗相比,BEMPEG加NIVO在以前未经治疗的患有无法切除或转移性黑色素瘤的患者的疗效和安全性.
- 评估客观反应率 (ORR),无进展生存率 (PFS) 和整体生存率 (OS) 作为主要终点.
- 分析二次疗效测量,安全性概况和药理动力学/药理动力学特征.
主要方法:
- 一个第三阶段,随机,开放的标签研究 (PIVOT IO 001) 涉及783名患者.
- 患者被分配1:1接受BEMPEG加NIVO或NIVO单疗法.
- 主要疗效终点包括ORR,PFS和OS,通过盲目的独立中央审查进行评估.
主要成果:
- 该研究没有达到其主要终点:ORR (27.7%对比36.0%),PFS中位数 (4.17对比4.99个月) 和OS中位数 (29.67对比28.88个月) 在组合中没有显著改善.
- 与治疗相关的3-4级不良事件和严重不良事件在BEMPEG加NIVO组 (21.7%和10.1%) 与NIVO单疗 (11.5%和5.5%) 相比较高.
- 药物动力学暴露和淋巴细胞计数变化与之前的研究一致.
结论:
- 在PIVOT IO 001研究中,未能证明BEMPEG加NIVO对NIVO单一治疗在一线转移性黑色素瘤中的益处.
- 组合疗法与毒性增加有关.
- 对晚期黑色素瘤的新疗法进行进一步的研究仍然至关重要.
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