4.7 Article

A Phase Ib Study of Durvalumab (MEDI4736) in Combination with Carbon-Ion Radiotherapy and Weekly Cisplatin for Patients with Locally Advanced Cervical Cancer (DECISION Study): The Early Safety and Efficacy Results

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MDPI
DOI: 10.3390/ijms241310565

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clinical trial; radiotherapy; heavy ion radiotherapy; cisplatin; durvalumab; uterine cervical neoplasms; carbon-ion radiotherapy; anti-PD-L1 antibody; concurrent chemoradiotherapy

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We conducted a phase Ib study to evaluate the safety of combining carbon-ion RT (CIRT) with durvalumab in patients with locally advanced cervical cancer. Three patients were enrolled and completed the treatment without interruption. One patient developed hypothyroidism, but recovered after treatment. No other serious adverse events (SAEs) were observed. All three patients achieved complete responses within the CIRT region. Further research is needed due to the small sample size of this study.
We conducted a phase Ib study to examine the safety of a combination of carbon-ion RT (CIRT) with durvalumab (MEDI4736; AstraZeneca) in patients with locally advanced cervical cancer. This was an open-label, single-arm study with a modified 3 + 3 design. Patients with newly diagnosed histologically proven locally advanced cervical cancer were enrolled. All patients received 74.4 Gy of CIRT in 20 fractions and concurrent weekly cisplatin (chemo-CIRT) at a dose of 40 mg/m(2). Durvalumab was administered (1500 mg/body) at weeks two and six. The primary endpoint was the incidence of adverse events (AEs) and serious AEs (SAEs), including dose-limiting toxicity (DLT). All three enrolled patients completed the treatment without interruption. One patient developed hypothyroidism after treatment and was determined to be an SAE. No other SAEs were observed. The patient recovered after levothyroxine sodium hydrate treatment. None of the AEs, including hypothyroidism, were associated with DLT in the present study. All three patients achieved complete responses within the CIRT region concerning treatment efficacy. This phase 1b trial demonstrates the safety of combining chemo-CIRT and durvalumab for locally advanced cervical cancer in the early phase. Further research is required as only three patients were included in this study.

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