Izhodišče: Zdravilo bevacizumab uporabljamo v sklopu primarnega sistemskega zdravljenja napredovalega epitelijskega raka jajčnikov v kombinaciji s paklitakselom in karboplatinom od leta 2013. Namen: ...Prikazati učinkovitost in varnost zdravljenja z bevacizumabom v redni klinični praksi v sklopu primarnega zdravljenja raka jajčnikov. Metode: V retrospektivno analizo smo vključili bolnice z epitelijskim rakom jajčnikov, ki so pričele zdravljenje z bevacizumabom na Onkološkem inštitutu Ljubljana v obdobju 1.1.2013 – 31.12.2016. Cilja raziskave sta bila varnost in učinkovitost (preživetje brez ponovitve bolezni, celokupno preživetje) zdravljenja z bevacizumabom. Raziskavo je odobrila etična komisija na Onkološkem Inštitutu Ljubljana. Rezultati: V opazovanem obdobju je bilo z bevacizumabom zdravljenih 111 bolnic z napredovalim epitelijskim rakom jajčnikov. Najpogostejši neželeni učinki so bili: bolečine (52%), krvavitev (45%), arterijska hipertenzija (44%). Resne neželene učinke (stopnja 3/4) je imelo 12% bolnic: 3% venska tromboza/embolija, 3% proteinurija, 2% arterijska hipertenzija, 2% krvavitev, 1% bolečine, 1% fistula. Mediani čas sledenja je bil 59 mesecev. Mediano preživetje brez ponovitve bolezni je bilo 18 mesecev, mediano celokupno preživetje je bilo 41 mesecev. Zaključki: Zdravljenje z bevacizumabom v redni klinični praksi je varno in učinkovito - v skladu z do sedaj znanimi rezultati prospektivnih raziskav GOG 218 in ICON 7.
Atezolizumab, a programmed-death ligand-1 (PD-L1) inhibitor, is a novel treatment option for patients with metastatic urothelial cancer (mUC). Clinical prognostic factors, survival outcomes, and the ...safety of patients with mUC treated with atezolizumab, in a real-world setting, were investigated.
62 patients with mUC, treated at the Institute of Oncology Ljubljana between May 8th 2018 and Dec 31st 2019, were included. Response rates and immune-related adverse events (irAE) were collected. Progression-free survival and overall survival times were assessed using the Kaplan-Meier method. The Cox proportional hazards model was applied to identify the factors affecting survival.
Of 62 patients, five (8.1%) have not yet been evaluated and 20 (32%) died prior to the first radiographic evaluation. We observed clinical benefit in 19 (33%), objective response in 12 (21%), and complete response in five (9%) patients. Median overall survival for the whole population was 6.8 (95% CI, 2.6-11.0), for platinum-naïve 8.7 (95% CI: 0.8-16.5), and for the platinum-treated group 6.8 (95% CI, 3.7-10) months. At the 5.8 (0.3-23.1) month median follow-up, the median duration of the response was not reached. IrAE occurred in 20 (32%) patients and seven (11%) of them discontinued the treatment. Multivariate analysis in platinum-treated patients showed that a treatment-free interval of more than six months was prognostic for overall survival (OS).
Responses to atezolizumab led to long disease remission in a subset of our patients. The median OS in our real-world population was compromised by a large percentage of patients with poor ECOG performance status (PS). A treatment-free interval from chemotherapy was associated with the longer survival of platinum-treated patients with mUC receiving further atezolizumab.
PDF