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高剂量化疗用于多种或低风险的复发性生殖细胞瘤

Yago Nieto1, John F Ward1, Wayne Hofstetter2

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用gemcitabine/docetaxel/melphalan/carboplatin (GemDMC) 进行的连续高剂量化疗 (HDC) 在复发性生殖细胞瘤 (GCT) 中显示出有希望的存活率. 在这项研究中,贝瓦西祖马布没有改善结果.

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科学领域:

  • 癌症学
  • 癌症研究
  • 药理学

背景情况:

  • 复发性生殖细胞瘤 (GCT) 在标准治疗中表现不佳.
  • 高剂量化疗 (HDC) 与自身干细胞移植为一些GCT患者提供治疗选择.
  • 对多次复发或耐火性GCT需要新的治疗策略.

研究的目的:

  • 在复发性或耐火性GCT患者中评估配合贝瓦齐祖马布或不配合贝瓦齐祖马布的顺序性格姆西塔宾/ 德克塔塞尔/ 梅尔法兰/ 卡博普拉丁 (GemDMC) 的疗效.
  • 评估贝瓦西祖马布是否与HDC有协同作用,针对GCT血管性.
  • 确定这种疗法是否可以改善预期的结果.

主要方法:

  • 在三个队列中进行了一项涉及序列性贝瓦齐祖马布-GemDMC,其次是贝瓦齐祖马布-ifosfamide/carboplatin/etoposide (ICE) 的试验.
  • 资格标准包括第二次或后来的复发或低风险的第一次复发.
  • 结果在额外的试验之外的队列中得到验证.

主要成果:

  • 治疗了165名多次复发/ 耐药性GCT的男性患者.
  • 总体应答率为84. 5%,其中77%的患者获得完全或部分缓解.
  • 五年无复发存活率 (RFS) 和整体存活率 (OS) 分别为57. 1%和58. 3%.
  • 在接受贝瓦齐祖马布和不接受贝瓦齐祖马布的患者之间没有显著的结果差异.

结论:

  • 顺序的GemDMC- I) CE化疗有效地增加了低风险的复发性GCT,超过了预期的结果.
  • 在该患者群体中,贝瓦齐祖马布没有显著改善RFS或OS.
  • 已确定的治疗方案为晚期GCT患者提供了可行的治疗选择.