在一线治疗后,在晚期肝细胞癌中使用伊塔西提尼布
Alessandro Troiani1, Lingshan Hung1, David J Pinato1,2
1Division of Surgery and Cancer, Imperial College London, Hammersmith Hospital Campus, London, UK.
NPJ precision oncology
|February 11, 2026
概括
伊塔西提尼布是一种JAK1抑制剂,在晚期肝细胞癌 (HCC) 患者中表现出有前途的活性. 这项研究确定了一种转录基因特征,可以预测HCC.的治疗反应.
科学领域:
- 在瘤学瘤学.
- 肝病学 肝病学是一种肝病学.
- 炎症研究 炎症研究
- 药理学 药理学是指药理学的学科.
背景情况:
- 肝细胞癌 (HCC) 由慢性肝病引起,炎症驱动癌症的发展.
- 目前针对HCC的第一线疗法有效性有限,并且没有任何治疗方法专门针对潜在的肝炎.
- 需要新的治疗策略,特别是在先进的HCC患者中,这些患者在先前的治疗中取得了进展.
研究的目的:
- 研究选择性JAK1抑制剂itacitinib的安全性和有效性,作为高级HCC的第二或第三线疗法.
- 确定可预测HCC患者对伊塔西提尼布治疗反应的生物标志物.
- 评估与治疗相关的不良事件 (trAEs) 和临床结果,包括无进展生存率 (PFS) 和整体生存率 (OS).
主要方法:
- 在先前治疗中进展的19名晚期HCC (Child Pugh ≤B7) 患者每28天接受伊塔西提尼布 (400 mg QID).
- 通过每周,然后每28天进行一次不良事件监测 (CTC-AE v4.03) 来评估安全性.
- 每8周使用RECIST 1.1评估反应. 瘤和血清样本进行了转录和代谢分析.
主要成果:
- 最常见的trAEs包括血小板缺血 (31%),疲劳 (26%),以及手掌 - 脚掌红色素消散综合征 (26%). 发生了四种剂量限制性毒性 (血小板缺血症).
- 在47%的患者中,最佳整体反应是稳定的疾病. 中位数的PFS为3.5个月 (95%CI:2.6-4.5),中位数的OS为7.4个月 (95%CI:4.3-10.5).
- 确定了一种预测反应的转录组签名. 以前接受组合免疫治疗的患者表现出明显增加的进展风险 (HR 4.7,p=0.016).
结论:
- 伊塔西替尼 (Itacitinib) 作为高级HCC的第二或第三线治疗,具有可管理的安全性.
- 一个转录的签名已被确定为一种潜在的预测生物标志物,用于itacitinib响应在HCC.
- 需要进一步的研究,以探索伊塔西提尼布的作用,并优化患者在HCC治疗中的选择.
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