NEJM:索拉非尼治疗晚期和难治性硬纤维瘤的疗效

2018-12-20 xing.T MedSci原创

由此可见,在患有进行性、难治性或症状性硬纤维瘤的患者中,索拉非尼治疗显著延长了患者无进展生存期,并诱导了持久的反应性。

硬纤维瘤(也称为侵袭性纤维瘤病)是结缔组织肿瘤,可以发生于任何解剖位置,并侵入肠系膜、神经血管结构和内脏器官。没有标准的治疗手段。

近日,顶级医学期刊NEJM上发表了一篇研究文章,在这项双盲、3期试验中,研究人员随机分配了87名患有进行性、症状性或复发性硬纤维瘤的患者,分别接受索拉非尼(每日一次400mg)或匹配的安慰剂治疗。对于存在疾病进展的安慰剂组患者,允许对索拉非尼组进行交叉治疗。该研究主要终点是研究者评估的无进展生存期,还评估了客观反应和不良事件的发生率。

中位随访时间为27.2个月,索拉非尼组的2年无进展生存率为81%(95%可信区间[CI]为69至96),安慰剂组为36%(95%CI为22至57)(进展或死亡的风险比为0.13; 95%CI为0.05至0.31; P<0.001)。在交叉之前,索拉非尼组的客观缓解率为33%(95%CI为20至48),安慰剂组为20%(95%CI为8至38)。索拉非尼组患者的客观反应时间中位数为9.6个月(四分位数间距为6.6至16.7),安慰剂组为13.3个月(四分位数间距为11.2至31.1)。在接受索拉非尼治疗的患者中,最常报告的不良事件为1级或2级皮疹(73%)、疲劳(67%)、高血压(55%)和腹泻(51%)。

由此可见,在患有进行性、难治性或症状性硬纤维瘤的患者中,索拉非尼治疗显著延长了患者无进展生存期,并诱导了持久的反应性。

原始出处:


Mrinal M. Gounder,et al.Sorafenib for Advanced and Refractory Desmoid Tumors.NEJM.2018.https://www.nejm.org/doi/full/10.1056/NEJMoa1805052

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    2023-03-10 showtest 来自上海
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    2018-12-22 freve
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    2018-12-20 内科新手

    谢谢williamhill asia 提供这么好的信息,学到很多

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研究发现,没有突变、基因扩增或可检出基因特征可以预测索拉非尼的治疗效果,肝细胞靶向pERK以及微血管侵犯与肝癌不良预后相关

Hepatology:环素依赖性激酶5抑制剂,可改善索拉非尼在肝癌治疗中的反应:一种新的治疗策略

Cdk5抑制是改善索拉非尼治疗反应和防止索拉非尼治疗在肝癌中的逃逸的有效途径。值得注意的是,Cdk5是一种可寻址的靶点,经常在HCC中过表达;而使用Dinaciclib -临床测试的Cdk5抑制剂,很容易获得。研究为临床评价索拉非尼与Dinaciclib联合治疗晚期肝癌的疗效提供了依据。

Brit J Cancer:类血管生成素蛋白3能够阻断FAK的细胞核输入并有助于索拉非尼响应

索拉非尼不良的药物反应是一个重要的挑战。不良药物反应减少了肾细胞癌(RCC)患者的临床益处。因此,阐释恢复索拉非尼治疗响应的潜在机制具有中重要的意义。最近,有研究人员利用蛋白免疫印迹和免疫组化技术在2个RCC患者群体中测量了类血管生成素蛋白3(ANGPTL3)含量水平。在RCC细胞中,研究人员利用功能丧失和功能获得试验用来调查ANGPTL3在索拉非尼治疗中的生物学作用,还利用人类蛋白组芯片和免疫沉