目的回顾分析西安交大一附院上皮性卵巢癌患者一线化疗中的实际平均卡铂剂量,按照Calvert公式反推出曲线下面积(area under the curve,AUC),比较AUC剂量的差异对中国人群的疗效和安全性影响。方法纳入2012年1月1日至2022年1月1日之间在...目的回顾分析西安交大一附院上皮性卵巢癌患者一线化疗中的实际平均卡铂剂量,按照Calvert公式反推出曲线下面积(area under the curve,AUC),比较AUC剂量的差异对中国人群的疗效和安全性影响。方法纳入2012年1月1日至2022年1月1日之间在西安交大一附院首次接受紫杉醇+卡铂3周疗方案一线化疗的患者。根据AUC中位数,将患者分为高剂量和低剂量组,比较其客观缓解率(overall response rate,ORR)、疾病控制率(disease control rate,DCR)、无进展生存期(progression free survival,PFS)和总生存期(overall survival,OS),以及不良事件(adverse events,AEs)的发生率。结果共纳入153例患者,卡铂AUC的中位数为3.981(2.314~5.446)。AUC≥5的患者只有10.46%(16/153)。77例患者AUC<4,76例患者AUC≥4,两组患者基线特性无统计学差异(P>0.05)。两组的ORR分别为59.74%和57.89%,DCR分别为87.01%和85.53%;中位PFS分别为14、15.5个月,中位OS分别为50、55个月。上述结局指标在组间均无统计学差异(P>0.05)。血液学AEs中血红蛋白、中性粒细胞和血小板减少在组间有统计学差异;恶心呕吐、腹泻便秘、1-2级发热在组间有统计学差异(P<0.05)。此外,剂量限制性毒性(dose limiting toxicity,DLT)指标包括4级血小板减少和发热性中性粒细胞减少,在高剂量组发生率显著升高(P<0.05)。结论与国外指南推荐的卡铂AUC 5-6比较,我院卵巢癌一线化疗实际卡铂给药剂量普遍不足。低剂量组和高剂量组患者疗效没有统计学差异,但是鉴于高剂量组部分AEs发生风险增加、DLT风险增加,不建议盲目增加卡铂AUC剂量。展开更多
This review highlights therapeutic agents from recent cancer therapeutic trials showing the greatest potential for further clinical use for sunitinib in the near future. In fact, sunitinib is one of multi-tyrosine kin...This review highlights therapeutic agents from recent cancer therapeutic trials showing the greatest potential for further clinical use for sunitinib in the near future. In fact, sunitinib is one of multi-tyrosine kinase inhibitors;tyrosine kinases are enzymes, which transfer phosphate groups from ATP to the hydroxyl group of tyrosine residues on signal transduction molecules. Phosphorylation of signal transduction molecules, in turn, induces dramatic changes in tumor growth, including activation of angiogenesis and DNA synthesis. Therefore, sustain efforts have been directed for developing inhibitors for angiogenesis, which is the marginal process for tumor growth and development through targeting TKs. Almost if not all angiogenesis inhibitors target the vascular endothelial growth factor (VEGF) signaling pathway.展开更多
文摘目的回顾分析西安交大一附院上皮性卵巢癌患者一线化疗中的实际平均卡铂剂量,按照Calvert公式反推出曲线下面积(area under the curve,AUC),比较AUC剂量的差异对中国人群的疗效和安全性影响。方法纳入2012年1月1日至2022年1月1日之间在西安交大一附院首次接受紫杉醇+卡铂3周疗方案一线化疗的患者。根据AUC中位数,将患者分为高剂量和低剂量组,比较其客观缓解率(overall response rate,ORR)、疾病控制率(disease control rate,DCR)、无进展生存期(progression free survival,PFS)和总生存期(overall survival,OS),以及不良事件(adverse events,AEs)的发生率。结果共纳入153例患者,卡铂AUC的中位数为3.981(2.314~5.446)。AUC≥5的患者只有10.46%(16/153)。77例患者AUC<4,76例患者AUC≥4,两组患者基线特性无统计学差异(P>0.05)。两组的ORR分别为59.74%和57.89%,DCR分别为87.01%和85.53%;中位PFS分别为14、15.5个月,中位OS分别为50、55个月。上述结局指标在组间均无统计学差异(P>0.05)。血液学AEs中血红蛋白、中性粒细胞和血小板减少在组间有统计学差异;恶心呕吐、腹泻便秘、1-2级发热在组间有统计学差异(P<0.05)。此外,剂量限制性毒性(dose limiting toxicity,DLT)指标包括4级血小板减少和发热性中性粒细胞减少,在高剂量组发生率显著升高(P<0.05)。结论与国外指南推荐的卡铂AUC 5-6比较,我院卵巢癌一线化疗实际卡铂给药剂量普遍不足。低剂量组和高剂量组患者疗效没有统计学差异,但是鉴于高剂量组部分AEs发生风险增加、DLT风险增加,不建议盲目增加卡铂AUC剂量。
文摘This review highlights therapeutic agents from recent cancer therapeutic trials showing the greatest potential for further clinical use for sunitinib in the near future. In fact, sunitinib is one of multi-tyrosine kinase inhibitors;tyrosine kinases are enzymes, which transfer phosphate groups from ATP to the hydroxyl group of tyrosine residues on signal transduction molecules. Phosphorylation of signal transduction molecules, in turn, induces dramatic changes in tumor growth, including activation of angiogenesis and DNA synthesis. Therefore, sustain efforts have been directed for developing inhibitors for angiogenesis, which is the marginal process for tumor growth and development through targeting TKs. Almost if not all angiogenesis inhibitors target the vascular endothelial growth factor (VEGF) signaling pathway.