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Efficacy and safety of recombinant human lymphotoxin-α derivative with cisplatin and fluorouracil in patients with metastatic esophageal squamous cell carcinoma: A randomized, multicenter, open-label, controlled, phase 2b trial.
- Source :
- Cancer (0008543X); Oct2017, Vol. 123 Issue 20, p3986-3994, 10p
- Publication Year :
- 2017
-
Abstract
- <bold>Background: </bold>Recombinant human lymphotoxin-α derivative (rhLTα-Da) is a lymphotoxin-α derivative that is missing 27 N-terminal amino acid residues. Previous studies indicated a benefit from the addition of rhLTα-Da to cisplatin-based treatment in patients with metastatic esophageal squamous cell carcinoma. The current study was conducted to evaluate the efficacy and safety of rhLTα-Da plus cisplatin and fluorouracil (PF) in patients with mESCC.<bold>Methods: </bold>Patients from 15 centers in China were randomly assigned (1:1:1) to 3 arms (arm A, PF plus 10 μg/m2 daily rhLTα-Da; arm B, PF plus 20 μg/m2 daily rhLTα-Da; arm C, PF alone). The primary endpoints included progression-free survival (PFS) and the confirmed overall response rate (ORR). An exploratory analysis was performed to evaluate the role of serum tumor necrosis factor receptor II (TNFR II) in predicting the efficacy of rhLTα-Da.<bold>Results: </bold>Between September 2010 and May 2013, 150 patients were enrolled. No significant differences in either PFS or ORR were observed between the 3 arms. However, in a small subset of patients who had low serum TNFR II levels, the median PFS was significantly longer for those in arm B than for these in other 2 arms (7.2 months [95% confidence interval, 5.1-8.6 months] for arm B vs 3.5 months [95% confidence interval, 1.7-5.5 months] for arm A [P = .022] and 4.0 months [95% confidence interval, 3.2-6.3 months] for arm C [P = .027]). The addition of rhLTα-Da significantly increased the incidence of chills (P < .001).<bold>Conclusions: </bold>rhLTα-Da combined with the PF regimen failed to improve PFS and ORR in patients with mESCC, except in a small subset that had low serum TNFR II concentrations. Cancer 2017;123:3986-94. © 2017 American Cancer Society. [ABSTRACT FROM AUTHOR]
- Subjects :
- TREATMENT of esophageal cancer
SQUAMOUS cell carcinoma
CANCER treatment
TUMOR necrosis factors
CISPLATIN
FLUOROURACIL
DRUG efficacy
CLINICAL drug trials
THERAPEUTICS
ANTINEOPLASTIC agents
CELL receptors
COMPARATIVE studies
ESOPHAGEAL tumors
RESEARCH methodology
MEDICAL cooperation
PROGNOSIS
RECOMBINANT proteins
RESEARCH
STATISTICAL sampling
EVALUATION research
RANDOMIZED controlled trials
BLOOD
Subjects
Details
- Language :
- English
- ISSN :
- 0008543X
- Volume :
- 123
- Issue :
- 20
- Database :
- Complementary Index
- Journal :
- Cancer (0008543X)
- Publication Type :
- Academic Journal
- Accession number :
- 125461681
- Full Text :
- https://doi.org/10.1002/cncr.30845