北京大学学报(医学版) ›› 2022, Vol. 54 ›› Issue (5): 971-980. doi: 10.19723/j.issn.1671-167X.2022.05.026
张力1,龚继芳2,潘宏铭3,白玉贤4,刘天舒5,程颖6,陈亚池7,黄佳莹8,许婷婷8,葛飞娇8,许婉玲9,施佳10,胡夕春11,*(),沈琳2,*()
Li ZHANG1,Ji-fang GONG2,Hong-ming PAN3,Yu-xian BAI4,Tian-shu LIU5,Ying CHENG6,Ya-chi CHEN7,Jia-ying HUANG8,Ting-ting XU8,Fei-jiao GE8,Wan-ling HSU9,Jane SHI10,Xi-chun HU11,*(),Lin SHEN2,*()
摘要:
目的: 观察程序性细胞死亡配体1(programmed death-ligand 1,PD-L1)抑制剂阿替利珠单抗在中国高发实体瘤,包括食管癌(esophageal cancer,EC)、胃癌(gastric cancer,GC)、肝细胞癌(hepatocellular carcinoma,HCC)、鼻咽癌(nasopharyngeal cancer,NPC)和非小细胞肺癌(non-small cell lung cancer,NSCLC)患者中的药代动力学(pharmacokinetics,PK)、疗效和安全性数据。方法: 本研究为开放标签的Ⅰ期临床试验,于2016年8月4日至2019年4月15日在中国6个研究中心进行。入组患者年龄≥18岁,患有经组织学证实的无法治愈或转移性的实体瘤,且既往抗肿瘤治疗失败。PK阶段研究了阿替利珠单抗单药治疗的PK和安全性;扩展阶段研究了阿替利珠单抗单药治疗(入组EC、GC、HCC、NPC患者)和联合化疗(入组NSCLC患者)的安全性和有效性。结果: 共入组120例患者(PK阶段20例;扩展期每队列20例)。阿替利珠单抗单药组患者(n=100)中有42例(42.0%)为PD-L1阳性,9例(9.0%)为微卫星高度不稳定性。阿替利珠单抗的清除率为0.219 L/d,重复给药6~9周(2~3个周期)后达到稳态。EC、GC、HCC、NPC和NSCLC的客观缓解率(objective response rate,ORR)分别为10.0%、15.0%、10.0%、5.0%和40.0%。在PD-L1阳性的肿瘤患者中,阿替利珠单抗的ORR为11.9%,阿替利珠单抗联合吉西他滨和顺铂的ORR为46.2%。2例GC患者在假性进展后获得了持久的肿瘤缩小。阿替利珠单抗单药组最常见的治疗相关不良事件是疲劳、贫血、发热和白细胞计数减少,联合组最常见的治疗相关AE是贫血、白细胞计数减少和食欲下降。本试验没有发现新的安全信号。结论: 中国患者应用阿替利珠单抗的PK、疗效和安全性与之前研究中入组的全球患者的数据相似。
中图分类号:
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