Everolimus(伊维莫司)
本帖最后由 虎光着 于 2018-8-24 18:55 编辑Phase II trial of bevacizumab (B) plus everolimus (E) for refractory metastatic colorectal cancer (mCRC).
Background: For patients (pts) with mCRC, treatment options are absent after progression on 5-FU, oxaliplatin, irinotecan, bevacizumab, and cetuximab/panitumumab. Preclinical data demonstrate combined VEGF and mTOR inhibition has greater antiangiogenic and antitumor activity than either monotherapy, and phase I data demonstrated that the combination of B + E is safe and generally well tolerated. This phase II trial evaluates efficacy and tolerability of B+E in mCRC patients who have progressed on standard therapies. Methods: 50 pts with refractory mCRC were treated with B 10 mg/kg q2 wks and E 10 mg PO QD until progression. Blood, skin, and tumor biopsies pre- and on-treatment were collected for markers of response and resistance. Results: 47 of 50 pts had prior B exposure; 42 pts had previously progressed on B. Median number of prior regimens was 4. Although no complete or partial responses were seen, 46% of pts achieved disease control for a median duration of 6.1 months (mos) (range 2.3-12.6): 8 pts had minor responses (median duration of response 4.1 mos, range 2.3-11.9+) and an additional 15 patients had SD (median duration of response 6.7 mos, range 3.2-12.6+). Three patients with prolonged stable disease have been on treatment > 1 year. There was one grade (Gr) 4 adverse event (AE) of hypokalemia. Noteworthy grade 3 AEs related to treatment were hypertension (n = 7), mucositis/proctitis (n = 3), fistula/abcess (n = 3), bowel perforation (n = 1), azotemia/proteinuria (n = 2), fatigue (n = 2), thrombocytopenia (n = 2), hyperglycemia (n = 6), hypokalemia (n = 6), hypophosphatemia (n = 2), hyperlipidemia (n = 3) and hyperbilirubinemia (n = 2). There was one Gr 3 event each of rhabdomyolysis, neuropathy, volume depletion, prolonged QT interval, GI hemorrhage and neutropenia. Other events of interest were: Gr 1-2 mucositis (68%, n = 34), Gr 1-2 hyperlipidemia (64%, n = 32). Biomarker data is pending. Conclusions: B + E has promising activity in refractory mCRC (even in pts who have progressed on a B-based regimen) with a disease control rate of 46%, suggesting B + E may overcome resistance to B.
依维莫司（Everolinus）是诺华公司开发的用来预防移植器官排斥反应的药物，后因其mTOR靶点独特的抗肿瘤活性而越来越受到人们的重视。上述临床是依维莫司联合阿瓦斯汀针对经历过所有标准治疗后的转移性结直肠癌患者的二期临床实验。实验数据结果相当不错，特别是对于之前一直运用阿瓦进行治疗的患者，联合伊维莫司仍然有效，这是极为难得的。这也为经历过所有标准治疗无效后的患者提供了一种可行的治疗方案。期待有更大型的联合实验开展来获取更多的有效数据。 不太了解这种药 这是个好消息，不知道价格怎么样 依维莫斯也可以治疗神经内分泌肿瘤。 这是一个神奇的药
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