Targeting vascular endothelial growth factor in advanced carcinoid tumor: a random assignment phase II study of depot octreotide with bevacizumab and pegylated interferon alpha-2b.
Targeting vascular endothelial growth factor in advanced carcinoid tumor: a random assignment phase II study of depot octreotide with bevacizumab and pegylated interferon alpha-2b.
复制标题
晚期类癌中靶向血管内皮生长因子：奥曲肽与贝伐珠单抗和聚乙二醇化干扰素 α-2b 联合使用的随机分配 II 期研究。
DOI：
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发表时间：
2008
影响因子：
45.3
通讯作者：
J. Ajani
中科院分区：
文献类型：
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作者：
James C. Yao;A. Phan;P. Hoff;Helen X. Chen;C. Charnsangavej;S. Yeung;K. Hess;C. Ng;J. Abbruzzese;J. Ajani
目的
对晚期类癌缺乏有效的系统治疗。在转移性或不可切除的类癌患者中评价了贝伐单抗（BEV）和聚乙二醇（PEG）干扰素α-2b的联合治疗。
患者和方法
44例接受稳定剂量奥曲肽治疗的患者被随机分配接受18周的贝伐单抗或PEG干扰素α-2b治疗。在疾病进展（PD）或18周结束时（以先发生者为准），患者接受贝伐珠单抗加PEG干扰素治疗，直至疾病进展。进行功能性计算机断层扫描（CT）以测量对肿瘤血流的影响。
结果
在贝伐珠单抗组中，4例患者（18%）达到确认的部分缓解（PR），17例患者（77%）病情稳定（SD），1例患者（5%）出现PD。在PEG干扰素组中，15例患者（68%）患有SD，6例患者（27%）患有PD。单药治疗18周后，贝伐单抗组的无进展生存率（PFS）为95%，而PEG干扰素组为68%。与功能性CT扫描的配对基线测量值相比，我们观察到贝伐单抗治疗患者在第2天和第18周的肿瘤血流量分别减少了49%（P <0.01）和28%（P <0.01）。PEG干扰素治疗后肿瘤血流无明显变化。PEG干扰素α-2b治疗与血浆碱性成纤维细胞生长因子（bFGF; P = 0.04）的降低和血浆白细胞介素-18（IL-18; P <0.01）的增加相关。贝伐单抗治疗后，未观察到bFGF或IL-18的显著变化。
结论
与PEG干扰素治疗相比，贝伐珠单抗治疗导致类癌患者的客观缓解、肿瘤血流量减少和PFS延长。
PURPOSE
Effective systemic therapy for advanced carcinoid is lacking. The combination of bevacizumab (BEV) and pegylated (PEG) interferon alpha-2b was evaluated among patients with metastatic or unresectable carcinoid tumors.
PATIENTS AND METHODS
Forty-four patients on stable doses of octreotide were randomly assigned to 18 weeks of treatment with bevacizumab or PEG interferon alpha-2b. At disease progression (PD) or at the end of 18 weeks (whichever occurred earlier), patients received bevacizumab plus PEG interferon until progression. Functional computer tomography (CT) scans were performed to measure effect on tumor blood flow.
RESULTS
In the bevacizumab arm, four patients (18%) achieved confirmed partial response (PR), 17 patients (77%) had stable disease (SD), and one patient (5%) had PD. In the PEG interferon arm, 15 patients (68%) had SD and six patients (27%) had PD. Progression-free survival (PFS) rates after 18 weeks of monotherapy were 95% in bevacizumab versus 68% on the PEG interferon arm. The overall median PFS for all 44 patients is 63 weeks. Compared with paired baseline measurements on functional CT scans, we observed a 49% (P < .01) and 28% (P < .01) decrease in tumor blood flow at day 2 and week 18 among patients treated with bevacizumab. No significant changes in tumor blood flow were observed following PEG interferon. PEG interferon alpha-2b treatment was associated with decrease in plasma basic fibroblast growth factor (bFGF; P = .04) and increase in plasma interleukin-18 (IL-18; P < .01). No significant changes in bFGF or IL-18 following treatment with bevacizumab were observed.
CONCLUSION
Bevacizumab therapy resulted in objective responses, reduction of tumor blood flow, and longer PFS in patients with carcinoid than PEG interferon treatment.
影响因子：
45.3
作者：
Sun, WJ;Lipsitz, S;Haller, DG
通讯作者：
Haller, DG