卡博赞提尼布与托波特坎-cyclophosphamide联合用于患有复发Ewing肉瘤或骨肉瘤的患者的第一阶段研究
Kevin Campbell1, Andrew Posner1, Nan Chen1
1Dana-Farber/Boston Children's Cancer and Blood Disorders Center and Harvard Medical School, Boston, Massachusetts, USA.
Pediatric blood & cancer
|September 16, 2023
概括
这一第一阶段试验确定了卡博桑提尼布,托波特坎和环胺在复发性瘤中的安全剂量. 推的第二阶段剂量涉及非同时使用的药物,显示出疾病控制的潜力.
科学领域:
- 儿科瘤学 儿科瘤学
- 医学瘤学 医学瘤学
- 药理学 药理学是指药理学的学科.
背景情况:
- 复发性骨髓瘤和尤文瘤的治疗选择有限.
- 与化疗相结合的向疗法可以改善结果.
- 卡博桑提尼布是一种多向的氨酸激酶抑制剂.
研究的目的:
- 评估卡博桑提尼布与托波特干和环胺联合使用的安全性和毒性.
- 为了确定该组合治疗的推第二阶段剂量 (RP2D).
- 为了评估复发性骨髓瘤和尤宁瘤患者的初步疗效.
主要方法:
- 一期临床试验,采用修改后的3+3剂量升级设计.
- 口服卡博桑提尼布每天用两种剂量 (25 mg/m2 21 天或 14 天).
- 静脉输入的托波特干 (0.75 mg/m2) 和环胺 (250 mg/m2) 在1-5天内给予.
主要成果:
- 招募了12名患者 (7名尤宁肉瘤,5名骨肉瘤),并对毒性进行了评估.
- 剂量水平1 (cabozantinib 25 mg/m2 1-21天) 在3/6名患者中显示出剂量限制性毒性 (DLT).
- 剂量水平-1B (cabozantinib 25 mg/m2 8-21天) 在6名患者中有1名DLT;观察到1名部分反应和7名稳定疾病.
结论:
- 推的第二阶段剂量:托波特干0.75 mg/m2 IV 1-5天,环胺 250 mg/m2 IV 1-5天,卡博桑提尼布 25 mg/m2 8-21天.
- 卡博桑提尼布与细胞毒性化疗不同时使用,表明可接受的毒性.
- 这种组合显示出在复发性骨髓瘤和尤文瘤中控制疾病的潜力.
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