JP2016512506A - 肺がんを処置する方法 - Google Patents
肺がんを処置する方法 Download PDFInfo
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- JP2016512506A JP2016512506A JP2016500945A JP2016500945A JP2016512506A JP 2016512506 A JP2016512506 A JP 2016512506A JP 2016500945 A JP2016500945 A JP 2016500945A JP 2016500945 A JP2016500945 A JP 2016500945A JP 2016512506 A JP2016512506 A JP 2016512506A
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Abstract
Description
本願は、その内容が本明細書において参考としてその全体において援用される、2013年3月12日に出願された、米国仮特許出願第61/778,299号に対する優先権を主張する。
NSCLCを処置するための新しいアプローチの継続的な評価は、NSCLC患者の生存期間の増加およびクオリティオブライフの向上に欠かせないことである。
本明細書中で言及する全ての出版物、特許、特許出願および公開された特許出願の開示は、参照によってその全体を本明細書中に組み込む。
定義
NSCLCを処置する方法
ナノ粒子組成物の投薬および投与方法
ナノ粒子組成物
ナノ粒子組成物中の他の成分
キット、薬および組成物
追加の例示的な実施形態
進行非小細胞肺がん(NSCLC)の患者における第一選択療法としてのTaxol(登録商標)およびCarboplatin(登録商標)と比較した、Nab−パクリタキセルおよびカルボプラチン(登録商標)の無作為化第III相試験
臨床試験は、進行NSCLCの患者における第一選択療法として、Nab−パクリタキセル+カルボプラチン(AUC=6)と、Taxol(登録商標)およびカルボプラチン(AUC=6)とを、疾患反応(RECISTガイドラインを使用)について比較した。臨床研究により、CTCAE、無増悪生存(PFS)、患者の生存、奏効している患者における奏効の持続期間、薬物動態パラメーターの評価、ならびに腫瘍組織および末梢血中の酸性でありシステインに富んだ分泌タンパク質(SPARC)およびその他の分子バイオマーカーの評価を使用して、毒性グレードの度数を比較し、それらの有効性アウトカムとの相関の可能性を決定した。
処置デザイン
B AE/SAEの報告は、患者が治験薬を中止したか、またはEOSのいずれか遅い方の後30日間続けた。この間に始まった任意のAE/SAEもまた追跡した。EOSの訪問においてAEまたはSAEの継続がなかった場合、追跡調査は、患者への電話により週に1回、処置の最後の用量から30日間まで実施した。
C 妊娠検査は、妊娠の可能性のある女性にのみ必要とした。血清β−hCG妊娠検査を実施し、治験薬の初回投与の72時間以内に患者の適格性を評価した。
D ECGを、ベースラインおよび治験責任医師によって臨床的に有意であると決定されたサイクルの任意の他の段階において実施した。
E 分子バイオマーカーに関する試料を、治験薬の初回投与前2週間以内に得た(サイクル1の1日目、研究の化学療法の投与前を含む)。その後の全ての試料は、奇数番号のサイクル(サイクル3、5、7など)の1日目に、治験薬の投与前に採取した。
F 全ての患者は、RECIST基準によりX線写真上で確認された測定可能な腫瘍(複数可)を有した。胸部、腹部および肝臓のCTスキャンを、ベースライン、処置中の6週間ごと(6週目の間の任意の時間において)およびEOS(規定された研究イメージングスケジュールにより必要とされる場合のみ)に実施した。ベースラインにおいて、腫瘍追跡のために選択された評価の方法は研究期間を通して一貫して続けるべきである。
G 処置中6週間ごとに、奏効評価のためのスキャンを得た。
H 再現研究をまた、他に進行の明らかな臨床的証拠がある場合を除いて、規定された研究イメージングスケジュールにより必要とされる場合のみ、EOSの訪問において実施した。
I 脳への転移の症状が存在する場合、頭部のCTスキャンまたは脳のMRIを実施した。
J 骨転移の可能性のある臨床症状を有する任意の患者に対して、核医学的骨スキャンをベースラインにおいて実施した。骨スキャンにおいて転移の可能性を同定した全ての領域について(これは決定的ではないため)、その後、単純フィルムX線を実施し、実際に転移しているかを検証した。これらの確定X線研究はベースラインにおいてのみ実施し、その後の骨スキャンにおいて反復する必要はなかった。骨スキャンは、12週ごと、および客観的奏効が最初に確認されたかまたは最初に確定されたときに反復した。
K BSAをベースラインにおいて計算し、ベースラインから10%を超えて体重が変化した場合に再計算した。
L 各サイクルの1日目または各サイクルの1日目の前1週間以内。
M 各サイクルの1日目または各サイクルの1日目の前1週間以内。末梢神経障害の発症は、AEまたはSAEとしてプロトコールどおりに治験責任医師より報告された。
N 研究後の追跡調査により患者の生存を提供した。電話による追跡調査を、6カ月間は月に1回、およびそこから12カ月間は3カ月ごとに(合計18カ月の追跡調査)実施した。研究開始から依然として進行がなかった患者に関して、無増悪生存追跡調査を、腫瘍イメージングに必要とされる研究を反復することによって6週ごとに実施した。骨スキャンを、非標的病変の確認に使用する場合は、12週ごとに実施した。
選択基準/除外基準
投薬量および投与
処置群A(Nab−パクリタキセル/カルボプラチン)
処置群B(タキソール/カルボプラチン)
Nab−パクリタキセル
タキソール
カルボプラチン
用量修正(全ての群)
有効性エンドポイント
測定可能病変および測定不能病変
標的および非標的病変の奏効
奏効
無増悪生存
患者の生存
安全性/忍容性エンドポイント
薬物動態のエンドポイント
検査室評価
分子バイオマーカーの評価
結果
(実施例2)
肺がんの処置
(実施例3)
進行非小細胞肺がん(NSCLC)の糖尿病患者における第一選択療法としてのカルボプラチンと併用するNab−パクリタキセル
(実施例4)
進行非小細胞肺がん(NSCLC)の患者における第一選択療法としてのカルボプラチンと組み合わせたNab−パクリタキセル:予後因子の分析
(実施例5)
進行非小細胞肺がん(NSCLC)のある高齢患者における第一選択療法としてのカルボプラチンと併用する週1回のnab(登録商標)−パクリタキセルの安全性および有効性
Claims (21)
- 個体のNSCLCを処置する方法であって、a)パクリタキセルおよびアルブミンを含むナノ粒子を含む組成物の有効量ならびにb)白金系薬剤の有効量を該個体に投与するステップを含み、処置が、該個体が(i)糖尿病を有し、(ii)4つまたはそれ超の転移部を有し、かつ(iii)少なくとも約70歳であるという特性のうち1つまたは複数を有することに基づく、方法。
- 前記処置が、前記個体が糖尿病を有することに基づく、請求項1に記載の方法。
- 前記処置が、前記個体が4つまたはそれ超の転移部を有することに基づく、請求項1または2に記載の方法。
- 前記処置が、前記個体が少なくとも約70歳であることに基づく、請求項1から3のいずれか一項に記載の方法。
- (i)糖尿病を有し、(ii)4つまたはそれ超の転移部を有し、かつ(iii)少なくとも約70歳であるという特性のうち1つまたは複数に基づいて、処置する前記個体を選択するステップを含む、請求項1から5のいずれか一項に記載の方法。
- 前記個体が糖尿病を有することに基づいて、処置する該個体を選択するステップを含む、請求項5に記載の方法。
- 前記個体が4つまたはそれ超の転移部を有することに基づいて、処置する該個体を選択するステップを含む、請求項5または6に記載の方法。
- 前記個体が少なくとも約70歳であることに基づいて、処置する該個体を選択するステップを含む、請求項5から7のいずれか一項に記載の方法。
- 前記処置が、前記個体が扁平上皮癌を有することに基づく、請求項1から8のいずれか一項に記載の方法。
- パクリタキセルおよびアルブミンを含むナノ粒子を含む前記組成物中のパクリタキセルの用量が、約50mg/m2から約125mg/m2の間である、請求項1から9のいずれか一項に記載の方法。
- パクリタキセルおよびアルブミンを含むナノ粒子を含む前記組成物が週1回投与される、請求項1から10のいずれか一項に記載の方法。
- 前記白金系薬剤の前記有効量が、約AUC=2から約AUC=6の間である、請求項1から11のいずれか一項に記載の方法。
- 前記白金系薬剤が3週間に1回投与される、請求項1から12のいずれか一項に記載の方法。
- パクリタキセルおよびアルブミンを含むナノ粒子を含む前記組成物中のパクリタキセルの用量が100mg/m2であって週1回投与され、前記白金系薬剤の前記有効量がAUC=6であって3週間に1回投与される、請求項1から13のいずれか一項に記載の方法。
- 前記ナノ粒子中のパクリタキセルが、アルブミンでコーティングされている、請求項1から14のいずれか一項に記載の方法。
- 前記組成物中の前記ナノ粒子が、約200nm以下の平均直径を有する、請求項1から15のいずれか一項に記載の方法。
- 前記NSCLCが、ステージIIIBのNSCLCまたはステージIVのNSCLCである、請求項1から16のいずれか一項に記載の方法。
- パクリタキセルおよびアルブミンを含むナノ粒子を含む前記組成物ならびに前記白金系薬剤が、非経口的に投与される、請求項1から17のいずれか一項に記載の方法。
- パクリタキセルおよびアルブミンを含むナノ粒子を含む前記組成物ならびに前記白金系薬剤が、静脈内に投与される、請求項1から18のいずれか一項に記載の方法。
- 前記白金系薬剤がカルボプラチンである、請求項1から19のいずれか一項に記載の方法。
- 前記個体がヒトである、請求項1から20のいずれか一項に記載の方法。
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NZ630392A (en) | 2016-10-28 |
KR20150126038A (ko) | 2015-11-10 |
KR102191311B1 (ko) | 2020-12-15 |
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WO2014159171A1 (en) | 2014-10-02 |
IL240935B (en) | 2018-12-31 |
EP2968254A1 (en) | 2016-01-20 |
MX2015011752A (es) | 2015-12-07 |
CA2903454A1 (en) | 2014-10-02 |
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MX370662B (es) | 2019-12-19 |
CN105228612A (zh) | 2016-01-06 |
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US20160015681A1 (en) | 2016-01-21 |
CN110279864A (zh) | 2019-09-27 |
JP2019206593A (ja) | 2019-12-05 |
JP6349381B2 (ja) | 2018-06-27 |
JP2018080198A (ja) | 2018-05-24 |
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