在患有BRAF V600突变的儿科质瘤中,达布拉菲尼布加上特拉梅替尼布
Eric Bouffet1, Jordan R Hansford1, Maria Luisa Garrè1
1From the Hospital for Sick Children, University of Toronto, Toronto (E.B., U.T.); the Royal Children's Hospital, University of Melbourne, Murdoch Children's Research Institute, Melbourne, VIC, and the Women's and Children's Hospital, South Australia Health and Medical Research Institute, South Australian immunoGENomics Cancer Institute, and the University of Adelaide, Adelaide - all in Australia (J.R.H.); IRCCS Giannina Gaslini Institute, Genoa (M.L.G.), and IRCCS Bambino Gesù Children's Hospital, Catholic University of the Sacred Heart, Rome (F.L.) - both in Italy; Osaka City General Hospital, Osaka, Japan (J.H.); the Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago (A.P.-F.); Institut Curie, SIREDO Oncology Center, Paris Sciences et Lettres Research University, Paris (I.A.); the Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands (J.L.); Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow (L.P.); the Department of Neuropathology and Clinical Cooperation Unit Neuropathology (F.S.) and the Hopp Children's Cancer Center, German Consortium for Translational Cancer Research, and National Center for Tumor Diseases, German Cancer Research Center, Heidelberg University Hospital, Heidelberg, Germany (F.S., O.W.); the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore (K.J.C.); Children's National Hospital, Washington, D.C. (R.J.P.); Novartis Pharma, Basel, Switzerland (L.S., A.B.P.S.); Novartis Pharmaceuticals, East Hanover, NJ (M.R.); and the University College London Great Ormond Street Institute of Child Health, London (D.R.H.).
与BRAF V600突变的儿科低度质瘤标准化疗相比,达布拉费尼布加上特拉美丁尼布的疗效和安全性更高. 这种组合疗法为患有这种特定遗传标记物的年轻患者提供了改善的结果.
科学领域:
- 儿科瘤学 儿科瘤学
- 分子向疗法分子向疗法
- 临床试验 临床试验
背景情况:
- 患有BRAF V600E突变的儿科低度质瘤 (pLGG) 对传统化疗反应不佳.
- 以前的研究表明,单独或与特拉美丁尼布一起使用的达布拉费尼布,对具有BRAF突变的复发性pLGG有效.
研究的目的:
- 评估达布拉费尼布加上特拉美丁尼布作为儿科低度质瘤的第一线治疗方法,该质瘤携带BRAF V600突变.
- 将这种组合的疗效和安全性与标准化疗进行比较.
主要方法:
- 在一项2期随机试验中,BRAF V600突变的PLGG患者被分配给达布拉费尼布加上特拉美丁尼布或标准化疗 (碳白金/温克里斯) 在2:1的比例下.
- 主要终点是整体应答率;次要终点包括临床益处和无进展生存期.
主要成果:
- 达布拉费尼布加上特拉美丁尼布的整体应答率达到了47%,而化疗的总应答率为11% (P<0.001).
- 达布拉费尼布/特拉美丁尼布治疗的患者中,有86%的患者观察到临床益处,而接受化疗的患者中,这一比例为46%.
- 达布拉费尼布/特拉美丁尼布的中位数无进展生存时间显著延长 (20.1个月与7.4个月相比;P<0.001).
- 高度不良事件在达布拉费尼布/特拉美提尼布 (47%) 治疗时比化疗 (94%) 治疗更少.
结论:
- 与标准化疗相比,达布拉费尼布加上特拉美丁尼布在患有BRAF V600突变的儿科低度质瘤的第一线治疗中显示出更高的应答率和无进展生存率.
- 组合疗法具有更有利的安全性,支持其作为一线选择的使用.
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