A retrospective study on VCD/IE regimen combined with apatinib for advanced Ewing sarcoma unresponsive to chemotherapy
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摘要:
目的 评估VCD/IE方案（长春新碱+环磷酰胺+多柔比星与异环磷酰胺+依托泊苷交替）联合阿帕替尼治疗化疗失败进展期尤因肉瘤的疗效与安全性。 方法 回顾性研究2017年1月至2021年12月于华中科技大学同济医学院附属协和医院，接受VCD/IE方案联合阿帕替尼治疗化疗失败的进展期尤因肉瘤11例患者的临床资料。与同期接受阿帕替尼单药治疗的尤因肉瘤患者对比，评估该方案的疗效及安全性。主要观察终点为疾病无进展生存期（progression-free survival，PFS），次要观察终点为客观缓解率（objective response rate，ORR）、疾病控制率（disease control rate，DCR）、总生存时间（overall survival，OS）和不良反应（adverse event，AE）。 结果 共筛选出符合入排标准的联合治疗患者11例，阿帕替尼单药组10例。两组患者中位随访时间分别为19.5个月和14.5个月。其中男性占比分别为72.7%（8/11）和70%（7/10），平均年龄分别为18.1±6.7岁和20.8±15.7岁。VCD/IE方案联合阿帕替尼的ORR、DCR、中位PFS、中位OS分别为27.3%（3/11）、81.8%（9/11）、 6.4个月和10.9个月。阿帕替尼单药治疗的ORR、DCR、中位PFS、中位OS分别为0、62.5%（5/8）、1.8个月和4.1个月。联合用药期间，3～4级AE主要为化疗相关的中性粒细胞减少、贫血、血小板减少、粒缺性发热等，而阿帕替尼相关AE均为1～2级。AE总体可以耐受。 结论 VCD/IE方案联合阿帕替尼治疗化疗失败的进展期尤因肉瘤疗效明显优于阿帕替尼单药，AE可控。 Abstract:Objective To evaluate the efficacy and safety of VCD/IE combined with apatinib for patients with advanced Ewing sarcoma, unresponsive to chemotherapy. Methods The clinical data of patients with advanced Ewing sarcoma, who received VCD/IE regimen combined with apatinib in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, from January 2017 to December 2021, were retrospectively collected. Their clinical data were compared with those of patients who received apatinib as monotherapy during the same period. The primary endpoint was progression-free survival (PFS). The secondary endpoints evaluated were objective response rate (ORR), disease control rate (DCR), overall survival (OS), and adverse events (AE). Results Eleven patients who received the combined regimen met the inclusion criteria of this study. Ten patients managed with apatinib monotherapy were enrolled. The median follow-up time was 19.5 months and 14.5 months, respectively. Most participants were male (72.7% and 70%, respectively), aged (18.1 ±6.7) and (20.8 ±15.7) years old, respectively. The ORR, DCR, mPFS, and mOS of those in the combined regimen were 27.3% (3/11), 81.8% (9/11), 6.4 months, and 10.9 months, respectively. Meanwhile, the ORR, DCR, mPFS, and mOS of those in apatinib monotherapy were 0, 62.5% (5/8), 1.8 months, and 4.1 months, respectively. Patients that underwent the combined regimen experienced grade 3-4 AE, such as chemotherapy-related neutropenia, anemia, thrombocytopenia, and febrile neutropenia. In comparison, patients who underwent apatinib monotherapy experienced grade 1-2 adverse reactions. All adverse reactions were generally tolerable. Conclusions VCD/IE regimen combined with apatinib is superior than apatinib monotherapy in managing patients with advanced Ewing sarcoma unresponsive to chemotherapy; all adverse reactions were tolerable. -
Key words:
- Ewing sarcoma /
- apatinib /
- efficacy /
- adverse reactions /
- retrospective study
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