小中大三期临床的结果
Results of phase III trial of rh-endostatin (YH-16) in advanced non-small cell lung cancer (NSCLC) patients
Y. Sun, J. Wang, Y. Liu, X. Song, Y. Zhang, K. Li, Y. Zhu, Q. Zhou, L. You and C. Yao
Cancer Hosp Chinese Acad of Medcl Science, Beijing, China; Liaoning Provincial Cancer Hosp, Shenyang, China; Cancer Hosp, Guangxi Medcl Univ, Nanning, China; Zhejiang Provincial Cancer Hosp, Hangzhou, China; Tianjin Cancer Hosp, Tianjin, China; Thoracic Tumor Hosp, Beijing, China; West China Hosp, Sichun Univ, Chengdu, China; Medgenn Bioengeering Co., Yantai, China; Beijing Univ First Hosp, Beijing, China
7138
Background: Endostar (rh-endostatin, YH-16) is a new recombinant human endostatin developed by Medgenn Co. Ltd. Pre-clinical study indicates that it can inhibit tumor endothelial cell proliferation, angiogenesis, and tumor growth. Phase I and Phase II studies revealed that Endostar was effective as single agent with good tolerance in clinical use. This study is to compare the response rate, median time to progression (TTP), clinical benefit, and safety in patients with advanced NSCLC, treated with Endostar plus vinorelbine and cisplatin (NP) or placebo plus NP. Methods: 493 histology or cytology confirmed stage IIIB and IV NSCLC patients, life expectancy >3 months, and WHO performance status 0–2 patients were entered in a double-blind, placebo-controlled, prospectively randomized trial after stratification, either Arm A: NP plus Endostar (n=326; vinorelbine 25mg/m2 on day 1 and 5, cisplatin 30mg/ m2 on days 2 to 4, Endostar 7.5 mg/ m2 on days 1 to 14) or Arm B: NP plus placebo (n=167; vinorelbine 25mg/m2 on day 1 and day5, cisplatin 30mg/ m2 on days 2 to 4, 0.9% sodium-chloride 3.75 ml on days 1 to 14) every 3 weeks for 2–6 cycles, according to the response after the second cycles, i.e. CR,PR,SD continue to receive treatment; while PD stop treatment. The response and adverse effects were evaluated by an Independent Experts Evaluation Committee (IEEC) before open the code. Results: Of the 486 assessable patients, overall response rates were 35.4% in Arm A and 19.5% in Arm B (P=.0003). The median TTP were 6.3 and 3.6 months for Arm A and B respectively (P<.001). The clinical benefit rates were 73.3% in Arm A and 64.0% in Arm B (P=.035). Grade 3/4 neutropenia, anemia, nausea/vomiting were 28.5%, 3.4%, 8.0% respectively in Arm A, as compared with 28.2%, 3.0%, 6.6% in Arm B(P>.05). There were 2 treatment-related death in Arm A and 1 in Arm B (P>.05). Conclusion: The addition of Endostar to NP regimen resulted in significant and clinically meaningful improvement in response rate, median TTP, and clinical benefit rate compared with NP alone in advanced NSCLC patients. Recombinant rh-Endostatin in combination with chemotherapy showed a synergic activity and a favorable toxic profile in advanced cancer patients.