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早有证据阿西替尼效果比不上阿瓦斯丁,希望探讨原因

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6427 14 dgarden 发表于 2013-7-21 22:19:15 |

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本帖最后由 dgarden 于 2013-7-21 22:27 编辑

阿西替尼在非小细胞肺癌实验中作为辅助药物失败

主要内容是阿西替尼的中位无进展生存期为5.7月,阿瓦斯丁为6.1月;总生存期阿西替尼为10.6月,阿瓦斯丁为13.3月。


VIENNA – A once-promising small molecule did not improve treatment efficacy when added to standard platinum-based therapy for advanced non-small cell lung cancer (NSCLC), researchers reported.

A phase II trial of the tyrosine kinase inhibitor axitinib (Inlyta), combined with platinum-based doublet chemotherapy, was stopped early because of disappointing efficacy results, according to Chris Twelves, MD, of St James' University Hospital in Leeds, England, and colleagues.

In addition, the treatment was associated with a higher rate of adverse events leading to dose reductions and temporary halts to therapy compared with bevacizumab, when each one was added to platinum-based therapy, Twelves told a poster session at the annual meeting of the European Society for Molecular Oncology here.

The drug, approved for advanced renal cell carcinoma, blocks receptors for the vascular endothelial growth factor (VEGF), Twelves noted.

The monoclonal VEGF antibody bevacizumab (Avastin) is known to improve outcomes in NSCLC when added to platinum-based chemotherapy, and an early study showed axitinib as a single agent was active against advanced disease.

To study the issue in more detail, Twelves and colleagues enrolled 118 treatment-naive patients with advanced or recurrent nonsquamous NSCLC for a randomized open-label trial.

All patients were treated with a standard regimen of paclitaxel (Taxol) and carboplatin (Paraplatin), combined with either bevacizumab or axitinib.

The primary endpoint of the study was the rate of progression-free survival, while secondary endpoints included overall survival, objective response rates, the length of response, safety, and patient-reported outcomes.

But the axitinib arm of the study was stopped in April 2010 after a preliminary analysis showed numerically inferior progression-free and overall survival, as well as a higher rate of adverse events, compared with the bevacizumab arm, Twelves reported.

The final results showed no significant efficacy difference between the two arms, the researchers found:

Median progression-free survival among axitinib patients was 5.7 months, compared with 6.1 months for bevacizumab, yielding a nonsignificant hazard ratio of 1.093 in favor of bevacizumab.
Median overall survival for axitinib was 10.6 months, compared with 13.3 for bevacizumab, leading to a nonsignificant hazard ratio of 1.117 in favor of bevacizumab.
The objective response rates were 29.3% and 43.3% for axitinib and bevacizumab, respectively.
The median duration of response was 4.4 months for axitinib and 7 months for bevacizumab.

Also, axitinib was harder to tolerate than the older drug, Twelves and colleagues found.

Many of the treatment-emergent adverse events were higher in the axitinib arm, including diarrhea (47% versus 34%), decreased appetite (43% versus 22%), nausea (36% versus 32%), and neutropenia (31% versus 27%).

On the other hand, rates of hypertension were similar between arms, at 43% for axitinib and 42% for bevacizumab. Axitinib patients also showed less hair loss (36% versus 46%) and fatigue (34% versus 39%).

More axitinib patients stopped therapy because of adverse events -- 41%, compared with 31% in the bevacizumab arm.


原文链接 http://www.medpagetoday.com/MeetingCoverage/ESMO/35172


16条精彩回复,最后回复于 2015-5-15 13:51

新咖啡男人  大学二年级 发表于 2014-11-17 23:00:30 | 显示全部楼层 来自: 山东烟台
那也可以啊                        5个月
seacat  版主 发表于 2014-11-18 00:57:52 | 显示全部楼层 来自: 广东广州
PFS没啥区别,主要是客观反应率阿西比贝伐低导致OS差别大。

原因应该就是贝伐是单抗类药物,跟化疗药有协同作用。
真想一觉醒来,我在小学教室对着小学同桌说:“我做了好长一个梦。”
新咖啡男人  大学二年级 发表于 2014-11-18 18:18:14 | 显示全部楼层 来自: 山东烟台
阿西替尼     不贵啊
吻别  小学六年级 发表于 2015-2-28 23:31:18 | 显示全部楼层 来自: 福建
有没有阿西的说明书
累计签到:12 天
连续签到:1 天
[LV.3]与爱熟人
山东小杨  高中一年级 发表于 2015-4-29 07:44:31 | 显示全部楼层 来自: 山东威海
阿瓦斯丁是啥药啊?
用心良苦  初中三年级 发表于 2015-4-30 19:07:31 | 显示全部楼层 来自: 广东广州
可是阿西一月二三百元,阿瓦二万元

点评

阿西一月几十元。  发表于 2015-5-17 15:34
heinz666  禁止发言 发表于 2015-5-4 08:42:35 | 显示全部楼层 来自: 重庆
提示: 作者被禁止或删除 内容自动屏蔽
恰吗古  高中二年级 发表于 2015-5-5 22:36:09 来自手机 | 显示全部楼层 来自: 新疆乌鲁木齐
有盗版的几百一个月阿瓦吗
daaiwujiang  高中一年级 发表于 2015-5-13 14:30:01 | 显示全部楼层 来自: 河北石家庄
学习了

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