在PIK3CA-突变的晚期乳腺癌中使用基于Inavolisib的疗法
Nicholas C Turner1, Seock-Ah Im1, Cristina Saura1
1From the Royal Marsden Hospital and Institute of Cancer Research (N.C.T.) and the Centre for Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London (P. Schmid), London, and Roche, Welwyn Garden City (E.T., G.L.) - all in the United Kingdom; Seoul National University Hospital, Seoul National University College of Medicine, Cancer Research Institute, Seoul National University, Seoul, South Korea (S.-A.I.); Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona (C. Saura); Mass General Cancer Center, Department of Medicine, Harvard Medical School, Boston (D.J.); Winship Cancer Institute at Emory University, Atlanta (K.K.); Genentech, San Francisco (N.S., T.J.S., K.E.H., J.L.S., C. Song); the Breast and Early Drug Development Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College - both in New York (K.L.J.); the German Breast Group, Neu-Isenburg, and the Center for Hematology and Oncology Bethanien, Goethe University, Frankfurt - both in Germany (S. Loibl); the Division of Cancer Research and Clinical Medicine, Peter MacCallum Cancer Centre, Melbourne, VIC, and the Sir Peter MacCallum Department of Medical Oncology, University of Melbourne, Parkville, VIC - both in Australia (S. Loi); the Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand (P. Sunpaweravong); the Department of Medicine, University of Parma, Parma, and the Medical Oncology and Breast Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori," Meldola - both in Italy (A.M.); the Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Department of Breast Oncology, Peking University Cancer Hospital and Institute, Beijing (H.L.), Harbin Medical University, Harbin (Q.Z.), and the University Department of Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong (R.L.) - all in China; and Maria Skłodowska-Curie Institute of Oncology, Warsaw, Poland (Z.N.).
伊纳沃利西布与palbociclib-fulvestrant结合,显著改善了PIK3CA突变乳腺癌患者的无进展生存率. 这种组合治疗显示出增强的抗瘤活性,但也增加了毒性影响的发生率.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 伊纳沃利西布是PIK3CA突变的酸氨基醇3-酶α的强有力的抑制剂.
- 它促进突变p110α的降解,在临床前和早期阶段研究中显示与palbociclib-fulvestrant的协同效应.
研究的目的:
- 为了评估一线inavolisib加Palbociclib-fulvestrant与安慰剂加Palbociclib-fulvestrant在PIK3CA突变的晚期乳腺癌中的疗效和安全性.
主要方法:
- 一个第三阶段的双盲随机试验比较了inavolisib (每天9毫克) 加上palbociclib-fulvestrant与安慰剂加上palbociclib-fulvestrant.
- 这项研究包括患有PIK3CA突变,HR+,HER2-局部晚期或转移性乳腺癌的患者,此前已有内分泌治疗复发.
主要成果:
- 无进展生存时间的中位数是15.0个月的inavolisib与7.3个月的安慰剂 (HR 0.43,P<0.001).
- 客观反应率为58.4% (无伏利西布) 和25.0% (安慰剂).
- 与inavolisib一起观察到更高的中性质减退,高血糖和口腔炎的发生率,尽管由于不良事件而中止的发生率很低 (6.8%).
结论:
- 伊纳沃利西布加上palbociclib-fulvestrant显著改善了PIK3CA突变晚期乳腺癌的无进展生存率.
- 组合治疗显示出增加的毒性作用,但由于不良事件的患者中止率仍然很低.
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