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Journal of Oncology 3

Table 1: Current trials in ovarian/fallopian/peritoneal cancer.

Author N Prior lines Platinum S/R

∗

/ﬁrst line Regimen

∗∗

RR:CR + PR TTP/PFS median

BurgerRetal.[7]621-2 +/+ Single 21 % PFS 4.7mo

Cannistra et al. [8]442-3 +/+ Single 15.9% PFS 4.4 mo

Garcia et al. [9]701–3+/+ Combo 24% TTP 7.2 mo

Wright et al. [10]232–15

−/+ Combo 35 % TTP 5.6 mo

Chura et al. [11]155–15+/+ Combo 43 % PFS 3.9 mo

Nimeiri et al. [12]131–3 +/+ Combo 15 % PFS 4.1 mo

Monk et al. [13]322–10

−/+ Single 16 % PFS 5.5 mo

Simpkins et al. [14]252–12

−/+ Combo 28 % TTP 9.0 mo

McGonigle et al. [15]180–2

−/+ Combo 22% PFS 3.8 mo

Azad et al. [17] 13 NR NR Combo 46% NR

Micha et al. [16] 20 0 First line Combo 80% NR

Campos/Penson et al. [18, 19] 58 0 First line Combo 75% PFS:11mo

∗

Enrolled patients: platinum sensitive/resistant/ﬁrst line.

∗∗

Single bevacizumab or combination therapy with cytotoxic or other biological agents.

NR: not reported.

ICON 6

Randomized

Carboplatin/paclitaxel + placebo followed

by placebo for 18 months

Carboplatin/paclitaxel + Cediranib followed

by placebo for 18 months

Carboplatin/paclitaxel + Cediranib followed

by Cediranib for 18 months

Figure 2: ICON-6.

day on a 4-week on 2-week oﬀ schedule. Noted in this study

was the development of pleural eﬀusions during the 2-week

rest period. Of the seventeen patients that were studied 12%

of patients had a partial response, and 59% of patients had

disease stabilization. Currently the Harvard Cancer Center

Gynecological Group (NCT00768144) is conducting a phase

II trial using sunitinib in refractory ovarian caner patients.

The dose of sunitinib is held constant at 37.5 mg every day.

AMG 706 is an investigational inhibitor of vascular

endothelial growth factor receptors 1, 2, and 3, platelet-

derived growth factor receptor, and stem-cell factor receptor.

A Phase II Evaluation of AMG706 (NCT00574951) in the

Treatment of Persistent or Recurrent Epithelial Ovarian

Fallopian Tube or Primary Peritoneal Cancer is currently

active.

Matei et al. [26] reported on the activity of sorafenib in

patient with recurrent ovarian cancer. Sorafenib is a tyrosine

kinase inhibitor targeting raf and other receptor kinases

(VEGF-R, PDGF-R, Flt3, c-KIT). Patients received sorafenib

at 400 mg QD. Patients in this study have a 3% partial

response, and 20% of patients had stable disease for > than

6 months. Toxicities included rash, metabolic abnormalities,

gastrointestinal, cardiovascular, and pulmonary toxicity.

4. VEGF Trap (Aﬂibercept)

VEGF trap (Aﬂibercept) is fusion protein containing the

VEGF binding regions of both VEGFR-1 and 2 linked

through the Fc region of a human IgG1. Aﬂibercept binds

VEGF-A and neutralizes all VEGF-A isoforms plus placental

growth factor. This agent is currently being explored in plat-

inum resistant ovarian cancer. Columbo et al. [39]reported

the results of VEGF Trap in patients with symptomatic

malignant ascites. Aﬂibercept, 4 mg/kg, i.v. was administered

every 2 weeks, in patients with advanced ovarian cancer

and symptomatic ascites requiring frequent paracentesis. Pri-

mary endpoint was repeat paracentesis response rate (RPRR)

deﬁned as at least a doubling of time to the ﬁrst paracentesis

compared to a baseline average. Patients received 1–13 cycles

of aﬂibercept. The authors reported that the time to the

ﬁrst paracentesis was 12–205 days. Eight out of ten evaluable

patients achieved a RPRR response as per protocol. Adverse

events included bowel obstruction, nausea, vomiting,

anorexia, edema, and 1 case of bowel perforation. Tew et al.

[40] reported the preliminary results of a randomized phase

II study in patients with recurrent platinum-resistant epithe-

lial ovarian cancer. VEGF Trap was (2 or 4 mg/kg) adminis-

tered intravenously every 2 weeks in patients with recurrent

1 2 3 4 5 6 7 8 9 10 11 12

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