替莫唑胺联合舒尼替尼治疗转移性黏膜黑色素瘤的疗效及安全性

发布时间：2018-02-24 13:17

  本文关键词： 黏膜黑色素瘤 替莫唑胺 舒尼替尼　出处：《中国肿瘤生物治疗杂志》2017年08期 　论文类型：期刊论文

【摘要】：目的:探索替莫唑胺(temozolomide,TMZ)联合舒尼替尼(sunitinib,SUN)在转移性黏膜黑色素瘤治疗中的应用价值。方法:回顾性纳入我中心2008年8月至2016年12月间接受TMZ联合SUN治疗的晚期黏膜黑色素瘤患者。患者均无BRAF/NRAS突变,服用TMZ(200 mg/m~2,d 1~5)和SUN(37.5 mg,d 1~28)治疗,28 d为一个疗程,治疗直至病情进展或毒副反应无法耐受。主要观察客观有效率(ORR)、疾病无进展生存期(PFS)、总生存期(OS)和毒副反应发生率。结果:纳入的27例患者中,原发肠道4例、泌尿生殖道9例、鼻咽部5例、口腔7例、食管2例,有19例患者既往接受过抗肿瘤治疗,TMZ联合SUN治疗的中位治疗周期为3.0。治疗后ORR 19.2%,疾病控制率(DCR)81.5%,中位PFS(3.0±0.7)个月,中位OS(7.1±0.9)个月。全组患者中有4例存在KIT突变,提示存在KIT突变/扩增的患者使用KIT抑制剂可能获益。联合治疗耐受性良好,仅2例患者因出现血小板抑制Ⅳ级,将SUN调整剂量为25 mg。Ⅲ~Ⅳ级副反应包括血小板下降(19.2%)、白细胞下降(19.2%)和肝功能损害(3.9%),未发生治疗相关性死亡事件。结论:TMZ联合SUN是治疗转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 卤0.7 months. The median OS(7.1 卤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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