奥拉帕利联合曲美木单抗治疗复发性卵巢癌胚系BRCA1/2突变女性的I/II期研究
Olaparib plus tremelimumab in women with recurrent ovarian cancer and a germline BRCA1 or BRCA2 mutation: a phase I/II study
摘要
该多中心单臂I/II期研究纳入50例携带胚系BRCA1或BRCA2突变的复发性上皮性卵巢癌女性,评估PARP抑制剂奥拉帕利联合CTLA4免疫检查点抑制剂曲美木单抗的安全性与疗效。I期未见新毒性;联合安全队列中57%发生3/4级非血液学毒性,34.7%停用曲美木单抗。II期主要终点客观缓解率为32.7%,疾病控制率47.7%,中位无进展生存3.0个月,总生存24.3个月。探索性分析提示VSTM5或IFIT1B低表达与治疗获益及PFS改善相关,结论需生物标志物筛选获益人群。
原文摘要
Response rates to immune checkpoint blockade (ICB) in ovarian cancer are low. In preclinical studies, poly(ADP-ribose) polymerase inhibition (PARPi) synergized with CTLA4 ICB to achieve long-term survival in Brca1-deficient ovarian cancer models. Here we evaluated the safety and efficacy of combined treatment with the PARPi olaparib and the CTLA4 ICB tremelimumab for recurrent epithelial ovarian cancer in a multi-site single-arm phase I/II study enrolling 50 women with germline BRCA1 or BRCA2 mutations (NCT02571725). In phase I, no new toxicities were identified (n = 3). In the combined phase I and II safety cohort (n = 49), 57% of subjects experienced grade 3 or 4 non-hematologic toxicity, with tremelimumab discontinuation in 34.7%. The primary phase II endpoint, overall response rate was 32.7% (95% CI 19.5-45.8%), and disease control rate was 47.7% (95% CI 33.0-62.5%). Secondary outcomes were progression-free survival (PFS, 3.0 months, 95% CI 2.7-5.9), and overall survival (24.3 months, CI 14.9-30.4). In exploratory post-hoc biomarker analyses, low VSTM5 or IFIT1B expression was associated with treatment benefit and improved PFS (p 12 months in 6 subjects among this heavily pre-treated cohort highlight the need for biomarkers to select regimens for patients with recurrent ovarian cancer.
推荐理由:研究设计规范、来自高影响力期刊,但主题为卵巢癌肿瘤免疫联合治疗,与生殖医学/辅助生殖核心实践距离较远,仅对关注胚系BRCA相关生殖遗传咨询者有一定参考价值。
文献解读
尚未生成。