NEJM: Trastuzumab Deruxtecan治疗HER2阳性晚期胃癌II期效果显著

2020-06-18 MedSci原创 MedSci原创

在HER2阳性胃癌患者中,与化疗相比,Trastuzumab deruxtecan治疗可显著改善疗效和总生存率

Trastuzumab deruxtecan (DS-8201)是一种抗体偶联药物,由抗HER2(人表皮生长因子受体2)抗体、四肽基连接物和细胞毒性拓扑异构酶I抑制剂组成,近日研究人员评估了其对HER2阳性晚期胃癌患者的疗效。
 
在这项II期试验中, HER2阳性的晚期胃癌患者随机接受trastuzumab deruxtecan或化疗,入组标准我HER2阳性的胃或胃食管交界处腺癌患者,先前至少接受过2种治疗(包括曲妥珠单抗)后进展,Trastuzumab deruxtecan的剂量为每公斤体重6.4毫克,每3周1次。研究的主要终点是客观应答。次要终点包括总生存率、反应持续时间、无进展生存率、持续时间≥4周的持续应答和安全性。
 
187例患者参与研究,125例接受Trastuzumab deruxtecan,62例接受化疗(55例接受伊立替康和7例接受紫杉醇)。Trastuzumab deruxtecan组有51%的患者有客观反应,化疗组有14%的患者有客观反应。Trastuzumab deruxtecan组的总生存期长于化疗组(中位数,12.5个月vs 8.4个月;死亡危险比:0.59)。最常见的3级或更高级别的不良事件是中性粒细胞计数下降(在trastuzumab deruxtecan组中为51%,化疗组中为24%),贫血(38%和23%),白细胞计数下降(21%和11%)。共有12名患者发生Trastuzumab deruxtecan相关的间质性肺病或肺炎(9名患者中为1级或2级,3名患者中为3级或4级)。Trastuzumab deruxtecan组中发现一例药物相关死亡(由于肺炎)。
 
在HER2阳性胃癌患者中,与化疗相比,Trastuzumab deruxtecan治疗可显著改善疗效和总生存率。
 
原始出处:
 
Kohei Shitara et al. Trastuzumab Deruxtecan in Previously Treated HER2-Positive Gastric Cancer. N Engl J Med, June 18, 2020.

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    2020-12-03 bsmagic9140
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    2020-12-15 snf701207
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  4. [GetPortalCommentsPageByObjectIdResponse(id=1657335, encodeId=1a9e165e33592, content=<a href='/topic/show?id=3ca31e71903' target=_blank style='color:#2F92EE;'>#TRA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17719, encryptionId=3ca31e71903, topicName=TRA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=757b24868428, createdName=bsmagic9140, createdTime=Thu Dec 03 14:31:58 CST 2020, time=2020-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1912391, encodeId=b523191239142, content=<a href='/topic/show?id=4de7112046c' target=_blank style='color:#2F92EE;'>#mAb#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11204, encryptionId=4de7112046c, topicName=mAb)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25e7304, createdName=snf701207, createdTime=Tue Dec 15 08:31:58 CST 2020, time=2020-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1712445, encodeId=45cc1e124458e, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Wed Jun 02 01:31:58 CST 2021, time=2021-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1652423, encodeId=38011652423df, content=<a href='/topic/show?id=13d01e24509' target=_blank style='color:#2F92EE;'>#TEC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17245, encryptionId=13d01e24509, topicName=TEC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=852f24292001, createdName=shock_melon, createdTime=Fri Jul 24 12:31:58 CST 2020, time=2020-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1952124, encodeId=a5f719521243b, content=<a href='/topic/show?id=e56658621e' target=_blank style='color:#2F92EE;'>#deruxtecan#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5862, encryptionId=e56658621e, topicName=deruxtecan)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ce4238, createdName=dangious, createdTime=Wed Oct 14 04:31:58 CST 2020, time=2020-10-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1276617, encodeId=ea2d12e661749, content=<a href='/topic/show?id=59ed598e816' target=_blank style='color:#2F92EE;'>#晚期胃癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59878, encryptionId=59ed598e816, topicName=晚期胃癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=80c5136, createdName=drj2003, createdTime=Sat Jun 20 09:31:58 CST 2020, time=2020-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1308578, encodeId=ce3f13085e847, content=<a href='/topic/show?id=240f8e3234' target=_blank style='color:#2F92EE;'>#HER2阳性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8732, encryptionId=240f8e3234, topicName=HER2阳性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8409354, createdName=闆锋旦, createdTime=Sat Jun 20 09:31:58 CST 2020, time=2020-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035313, encodeId=83d5103531378, content=顶刊就是顶刊,谢谢williamhill asia 带来这么高水平的研究报道,williamhill asia 科里同事经常看williamhill asia ,分享williamhill asia 上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Jun 18 21:31:58 CST 2020, time=2020-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047083, encodeId=2728104e0838e, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Thu Jun 18 21:31:58 CST 2020, time=2020-06-18, status=1, ipAttribution=)]
    2020-07-24 shock_melon
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  7. [GetPortalCommentsPageByObjectIdResponse(id=1657335, encodeId=1a9e165e33592, content=<a href='/topic/show?id=3ca31e71903' target=_blank style='color:#2F92EE;'>#TRA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17719, encryptionId=3ca31e71903, topicName=TRA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=757b24868428, createdName=bsmagic9140, createdTime=Thu Dec 03 14:31:58 CST 2020, time=2020-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1912391, encodeId=b523191239142, content=<a href='/topic/show?id=4de7112046c' target=_blank style='color:#2F92EE;'>#mAb#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11204, encryptionId=4de7112046c, topicName=mAb)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25e7304, createdName=snf701207, createdTime=Tue Dec 15 08:31:58 CST 2020, time=2020-12-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1712445, encodeId=45cc1e124458e, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Wed Jun 02 01:31:58 CST 2021, time=2021-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1652423, encodeId=38011652423df, content=<a href='/topic/show?id=13d01e24509' target=_blank style='color:#2F92EE;'>#TEC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17245, encryptionId=13d01e24509, topicName=TEC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=852f24292001, createdName=shock_melon, createdTime=Fri Jul 24 12:31:58 CST 2020, time=2020-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1952124, encodeId=a5f719521243b, content=<a href='/topic/show?id=e56658621e' target=_blank style='color:#2F92EE;'>#deruxtecan#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5862, encryptionId=e56658621e, topicName=deruxtecan)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ce4238, createdName=dangious, createdTime=Wed Oct 14 04:31:58 CST 2020, time=2020-10-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1276617, encodeId=ea2d12e661749, content=<a href='/topic/show?id=59ed598e816' target=_blank style='color:#2F92EE;'>#晚期胃癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59878, encryptionId=59ed598e816, topicName=晚期胃癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=80c5136, createdName=drj2003, createdTime=Sat Jun 20 09:31:58 CST 2020, time=2020-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1308578, encodeId=ce3f13085e847, content=<a href='/topic/show?id=240f8e3234' target=_blank style='color:#2F92EE;'>#HER2阳性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8732, encryptionId=240f8e3234, topicName=HER2阳性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8409354, createdName=闆锋旦, createdTime=Sat Jun 20 09:31:58 CST 2020, time=2020-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035313, encodeId=83d5103531378, content=顶刊就是顶刊,谢谢williamhill asia 带来这么高水平的研究报道,williamhill asia 科里同事经常看williamhill asia ,分享williamhill asia 上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Jun 18 21:31:58 CST 2020, time=2020-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047083, encodeId=2728104e0838e, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Thu Jun 18 21:31:58 CST 2020, time=2020-06-18, status=1, ipAttribution=)]
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    2020-06-18 旺医

    顶刊就是顶刊,谢谢williamhill asia 带来这么高水平的研究报道,williamhill asia 科里同事经常看williamhill asia ,分享williamhill asia 上的信息

    0

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    2020-06-18 CHANGE

    疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的

    0

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