Clin Cancer Res：遗憾！阿特珠单抗+镭-223联合方案未能给mCRPC患者带来额外的临床效益

2021-09-04 Nebula MedSci原创

阿特珠单抗+镭-223联合方案未能给mCRPC患者带来额外的临床效益

转移性去势抵抗性前列腺癌 (mCRPC) 患者在激素治疗和化疗后，病情再发生进展时的治疗选择有限。为这部分患者探索新的治疗方案具有重要的临床意义。本研究评估了抗PD-L1抗体阿特珠单抗（atezolizumab）联合氯化镭-223（镭-223，是一种靶向α辐射源,可以选择性地结合到骨转移患者的骨代谢增高区并发射短程高能α粒子）在mCRPC患者中的抗肿瘤活性和安全性。

这是一项 Ib 期的临床试验，招募了经雄激素通路抑制剂治疗后病情进展的已发生骨和淋巴结和/或内脏器官转移的mCRPC患者，予以阿特珠单抗+镭-223治疗。评估了该联合方案的安全性后，45位患者以1:1:1的比例被随机分至三组，接受同时予以两种治疗或间隔一个疗程依次应用（第一个疗程先予以阿特珠单抗，从第二个疗程起加用镭-223，或反过来）。主要终点是安全性和客观缓解率（ORR）。次要终点包括无影像学检查进展生存期（rPFS）、PSA缓解和总生存期（OS）。

可评估患者的AE发生情况

截止2019年10月4日，45位患者中有44位可评估。这44位患者都至少发生过一次全因不良事件（AE）；23位（52.3%）发生过3/4级AE。经评估，15位（34.1%）患者的3/4级不良事件和3位（6.8%）的5级不良事件与阿特珠单抗治疗相关；无一例与镭-223相关。

三个治疗组的总存活率

经证实的ORR为6.8%（95%CI 1.4-18.7），中位rPFS为3.0个月（95%CI 2.8-4.6），中位PFS进展期为3.0个月（95%CI 2.8-3.3），中位OS为16.3个月（95%CI 10.9-22.3）。

该研究结果表明，无论予以治疗的先后顺序如何，阿特珠单抗联合镭-223用于骨和淋巴结和/或内脏器官转移的mCRPC患者的毒性反应均高于二者单用时，而且未能展现出额外的临床获益的明确证据。

原始出处：

Lawrence Fong, et al. A Phase Ib Study of Atezolizumab with Radium-223 Dichloride in Men with Metastatic Castration-Resistant Prostate Cancer. Clin Cancer Res. DOI: 10.1158/1078-0432.CCR-21-0063 Published September 2021

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2022-06-04 songbq

#镭-223#

73 0
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2021-12-30 王水

学习了

74 0
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2022-04-16 mashirong

#联合方案#

75 0
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2021-09-06 rebeccajiejie

#CRP#

75 0
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2021-09-06 智智灵药

#mCRPC#

78 0
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2021-09-06 flyingeagle82

#CRPC#

0 0
[GetPortalCommentsPageByObjectIdResponse(id=1929008, encodeId=267f192900855, content=<a href='/topic/show?id=b0f49684898' target=_blank style='color:#2F92EE;'>#镭-223#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96848, encryptionId=b0f49684898, topicName=镭-223)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=856b247, createdName=songbq, createdTime=Sat Jun 04 14:10:05 CST 2022, time=2022-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1178947, encodeId=ee8711e8947bd, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160424/IMG571CAE654CB878126.jpg, createdBy=b5c31716913, createdName=王水, createdTime=Thu Dec 30 20:07:29 CST 2021, time=2021-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1971904, encodeId=e98919e1904b7, content=<a href='/topic/show?id=f9c480e0860' target=_blank style='color:#2F92EE;'>#联合方案#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80708, encryptionId=f9c480e0860, topicName=联合方案)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f13d475, createdName=mashirong, createdTime=Sat Apr 16 03:10:05 CST 2022, time=2022-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1269626, encodeId=aabe1269626f1, content=<a href='/topic/show?id=ca6952e52f' target=_blank style='color:#2F92EE;'>#CRP#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5275, encryptionId=ca6952e52f, topicName=CRP)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e1cc90, createdName=rebeccajiejie, createdTime=Mon Sep 06 08:10:05 CST 2021, time=2021-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1555942, encodeId=b7a3155594279, content=<a href='/topic/show?id=641e1139ea8' target=_blank style='color:#2F92EE;'>#mCRPC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11397, encryptionId=641e1139ea8, topicName=mCRPC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Mon Sep 06 08:10:05 CST 2021, time=2021-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1569860, encodeId=7698156986019, content=<a href='/topic/show?id=bc1352e951' target=_blank style='color:#2F92EE;'>#CRPC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5279, encryptionId=bc1352e951, topicName=CRPC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5daa15584462, createdName=flyingeagle82, createdTime=Mon Sep 06 08:10:05 CST 2021, time=2021-09-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1014611, encodeId=04e9101461195, content=<a href='/topic/show?id=1d8de4257ef' target=_blank style='color:#2F92EE;'>#神经外科#</a>哪位老师有神经系统脱髓鞘疾病的临床指南？可否分享一下，谢谢，, beContent=null, objectType=article, channel=null, level=null, likeNumber=149, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74257, encryptionId=1d8de4257ef, topicName=神经外科)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210822/d15a561e055d4cdf98b4abace82dee37/464d5f63a8dd486ab01049225a87f788.jpg, createdBy=7fa65188499, createdName=杨小屁, createdTime=Sat Sep 04 20:26:41 CST 2021, time=2021-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1014610, encodeId=9c3b101461021, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210822/d15a561e055d4cdf98b4abace82dee37/464d5f63a8dd486ab01049225a87f788.jpg, createdBy=7fa65188499, createdName=杨小屁, createdTime=Sat Sep 04 20:25:18 CST 2021, time=2021-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1014607, encodeId=62c2101460e9c, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eea35208901, createdName=14756591m79暂无昵称, createdTime=Sat Sep 04 20:11:24 CST 2021, time=2021-09-04, status=1, ipAttribution=)]
2021-09-04 杨小屁

#神经外科#哪位老师有神经系统脱髓鞘疾病的临床指南？可否分享一下，谢谢，

149 0
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2021-09-04 杨小屁

学习了

97 0
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2021-09-04 14756591m79暂无昵称

学习了

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