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西妥昔单抗单药或联合化疗治疗局部晚期或转移性皮肤鳞状细胞癌的疗效及耐受性:一项针对14例患者的开放性研究

Efficacy and Tolerance of Cetuximab Alone or Combined with Chemotherapy in Locally Advanced or Metastatic Cutaneous Squamous Cell Carcinoma: An Open Study of 14 Patients.

作者信息

Dereure Olivier, Missan Hamoudeh, Girard Céline, Costes Valérie, Guillot Bernard

机构信息

Department of Dermatology, INSERM U1058, University of Montpellier, Montpellier, France.

出版信息

Dermatology. 2016;232(6):721-730. doi: 10.1159/000461578. Epub 2017 Apr 7.

Abstract

BACKGROUND/AIMS: Previous reports highlighted the potential interest of cetuximab alone or in combination with chemotherapy in locally advanced or metastatic cutaneous squamous cell carcinomas (cSCC) care.

MATERIAL AND METHODS

To further evaluate the efficiency and safety of cetuximab in advanced cSCC, a single-center retrospective study including all patients treated with cetuximab alone or combined with carboplatin for locally advanced or metastatic cSCC was conducted in a tertiary referral center. The primary end point was the overall response rate (ORR) after 2 cycles of treatment. Secondary end points were best overall disease control rate (DCR), overall survival (OS), best response duration, progression-free survival (PFS), and toxicity profile.

RESULTS

Of the 14 enrolled patients, no complete response was obtained after 2 cycles of treatment, but 3 partial responses and 6 stable diseases were observed. ORR and DCR were 21.4 and 64.3%, respectively. Median OS and PFS were 9.25 and 2.65 months, respectively. Median PFS was longer with combined treatment compared with cetuximab monotherapy (9.03 vs. 3.55 months). The safety profile was acceptable with a trend toward a relationship between acne-like rash and longer response (median PFS 5.2 vs. 2.2 months).

DISCUSSION/CONCLUSION: In all series including ours, disease control is usually rapidly obtained with cetuximab alone or combined with conventional chemotherapy, although with a minority of partial responses and no complete response. However, this control is of short duration in most cases. The safety profile is acceptable. A randomized phase III trial is warranted to better assess the benefit/risk ratio.

摘要

背景/目的:先前的报告强调了西妥昔单抗单独或与化疗联合用于局部晚期或转移性皮肤鳞状细胞癌(cSCC)治疗的潜在价值。

材料与方法

为进一步评估西妥昔单抗在晚期cSCC中的疗效和安全性,在一家三级转诊中心开展了一项单中心回顾性研究,纳入所有接受西妥昔单抗单药治疗或联合卡铂治疗局部晚期或转移性cSCC的患者。主要终点为2个周期治疗后的总缓解率(ORR)。次要终点为最佳总体疾病控制率(DCR)、总生存期(OS)、最佳缓解持续时间、无进展生存期(PFS)和毒性特征。

结果

14例入组患者在2个周期治疗后均未获得完全缓解,但观察到3例部分缓解和6例病情稳定。ORR和DCR分别为21.4%和64.3%。OS和PFS的中位数分别为9.25个月和2.65个月。与西妥昔单抗单药治疗相比,联合治疗的PFS中位数更长(9.03个月对3.55个月)。安全性良好,痤疮样皮疹与更长缓解期之间存在关联趋势(PFS中位数5.2个月对2.2个月)。

讨论/结论:在包括我们研究在内的所有系列研究中,单独使用西妥昔单抗或联合传统化疗通常能迅速实现疾病控制,尽管部分缓解较少且无完全缓解。然而,在大多数情况下,这种控制持续时间较短。安全性良好。有必要开展一项随机III期试验以更好地评估获益/风险比。

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