替莫唑胺聯合舒尼替尼治療轉移性黏膜黑色素瘤的療效及安全性
發(fā)布時間:2018-02-24 13:17
本文關鍵詞: 黏膜黑色素瘤 替莫唑胺 舒尼替尼 出處:《中國腫瘤生物治療雜志》2017年08期 論文類型:期刊論文
【摘要】:目的:探索替莫唑胺(temozolomide,TMZ)聯合舒尼替尼(sunitinib,SUN)在轉移性黏膜黑色素瘤治療中的應用價值。方法:回顧性納入我中心2008年8月至2016年12月間接受TMZ聯合SUN治療的晚期黏膜黑色素瘤患者;颊呔鶡oBRAF/NRAS突變,服用TMZ(200 mg/m~2,d 1~5)和SUN(37.5 mg,d 1~28)治療,28 d為一個療程,治療直至病情進展或毒副反應無法耐受。主要觀察客觀有效率(ORR)、疾病無進展生存期(PFS)、總生存期(OS)和毒副反應發(fā)生率。結果:納入的27例患者中,原發(fā)腸道4例、泌尿生殖道9例、鼻咽部5例、口腔7例、食管2例,有19例患者既往接受過抗腫瘤治療,TMZ聯合SUN治療的中位治療周期為3.0。治療后ORR 19.2%,疾病控制率(DCR)81.5%,中位PFS(3.0±0.7)個月,中位OS(7.1±0.9)個月。全組患者中有4例存在KIT突變,提示存在KIT突變/擴增的患者使用KIT抑制劑可能獲益。聯合治療耐受性良好,僅2例患者因出現血小板抑制Ⅳ級,將SUN調整劑量為25 mg。Ⅲ~Ⅳ級副反應包括血小板下降(19.2%)、白細胞下降(19.2%)和肝功能損害(3.9%),未發(fā)生治療相關性死亡事件。結論:TMZ聯合SUN是治療轉移性黏膜黑色素瘤的有效方案,且安全性良好。
[Abstract]:Objective: to explore the clinical value of temozolomide temozolomide (TMZ) combined with sunitinib#en0# in the treatment of metastatic mucosal melanoma. Methods: from August 2008 to December 2016, we included in our center the indirect treatment of advanced mucosal mucosa treated with TMZ and SUN. No BRAF/NRAS mutation was found in patients with melanoma. One course of treatment was taken by taking TMZ(200 mg / mg / mg 2d / d ~ (1 / 5) and SUN(37.5 / mg / d ~ (1 / 28)) for 28 days. The objective effective rate was observed, the disease survival time was PFSI, the total survival time (OS) and the incidence of side effects were observed. Results: among the 27 patients, 4 were primary intestinal tract, 4 were primary intestinal tract, 4 were primary intestinal tract, 4 were primary intestinal tract, 4 were primary intestinal tract, 4 were primary intestinal tract, 4 were primary intestinal tract, 4 were primary intestinal tract, and 4 were primary intestinal tract. There were 9 cases of genitourinary tract, 5 cases of nasopharynx, 7 cases of oral cavity and 2 cases of esophagus. The median treatment period of 19 patients who had been treated with antitumor therapy combined with SUN was 3.0.After the treatment, the disease control rate was 81.5 and the median PFS(3.0 鹵0.7 months. The median OS(7.1 鹵0. 9 months. There were 4 cases of KIT mutation in the whole group, which suggested that the patients with KIT mutation / amplification might benefit from the use of KIT inhibitor. The combination therapy had good tolerance, only 2 patients had grade 鈪,
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