Luvometinib在Langerhans细胞组织细胞增多症、Erdheim-Chester病和其他组织细胞肿瘤患者中的应用:单组、多中心、2期研究

IF 10 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
EClinicalMedicine Pub Date : 2025-09-17 eCollection Date: 2025-10-01 DOI:10.1016/j.eclinm.2025.103486
Xin-Xin Cao, Qi Zhu, Zhen Cai, Jie Ma, Hui Zhou, Long Chang, Lai-Ping Zhong, Zhu-Li Wu, Xingli Wang, Pu Han, Hong-Mei Lin, Zhen Wei, Jia-Yan Guo, Yang Zheng, Jian Li
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引用次数: 0

摘要

背景:组织细胞肿瘤是一种异质性的血液学疾病,其特征是体细胞有丝分裂原激活的蛋白激酶途径的高频率突变。这项单组、多中心、2期研究评估了选择性MEK1/2抑制剂鲁莫替尼对成年组织细胞肿瘤患者的疗效和安全性。方法:无论肿瘤基因型如何,treatment-naïve或复发/难治性患者(年龄在bb0 - 16岁)均被纳入研究,并接受口服luvometinib, 8mg,每天1次,28天周期,直到疾病进展、死亡、不可接受的毒性、撤回同意或研究结束。主要终点是由独立审查委员会根据正电子发射断层扫描反应标准评估的总反应率(ORR)。本试验已在chinadrutrials.org.cn (CTR20221069)和chictr.org.cn (ChiCTR2300067955)注册。研究结果:在2022年6月27日至2024年2月2日期间,30名患者入组;随访时间中位数为16.2个月(1.5-19.3个月)。在29例可评估的患者中,22例(75.9%)患有朗格汉斯细胞组织细胞增多症,3例(10.3%)患有厄德海姆-切斯特病,4例(13.8%)患有其他亚型。大多数(86.2%)患者以前接受过全身治疗,27.6%的患者接受过≥3条线的治疗。中位随访时间为16.2个月,ORR为82.8% (95% CI, 64.2-94.2),中位缓解时间为2.9个月(范围,2.6-6.0),中位缓解持续时间未达到。12个月无进展生存率为74.4% (95% CI, 49.8-88.2)。13例(43.3%)患者发生≥3级治疗不良事件,其中毛囊炎(10.0%)、高甘油三酯血症(10.0%)和血肌酸磷酸激酶升高(6.7%)发生在1例以上患者中。没有治疗中出现的不良事件导致停药。解释:Luvometinib在组织细胞肿瘤患者中表现出高且持久的反应和可管理的安全性。资助:上海复星医药产业发展有限公司
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Luvometinib in patients with Langerhans cell histiocytosis, Erdheim-Chester disease, and other histiocytic neoplasms: a single-arm, multicentre, phase 2 study.

Background: Histiocytic neoplasms are a heterogeneous group of haematologic disorders marked by a high frequency of mutations in the somatic mitogen-activated protein kinase pathway. This single-arm, multicentre, phase 2 study evaluated the efficacy and safety of the selective MEK1/2 inhibitor luvometinib in adult patients with histiocytic neoplasms.

Methods: Patients (aged >16 years), regardless of tumour genotype and who were either treatment-naïve or relapse/refractory, were enrolled and received oral luvometinib, 8 mg, once daily in 28-day cycles until disease progression, death, unacceptable toxicity, withdrawal of consent, or end of the study. The primary end point was overall response rate (ORR) assessed by an independent review committee according to positron emission tomography response criteria. This trial was registered with chinadrugtrials.org.cn (CTR20221069) and chictr.org.cn (ChiCTR2300067955).

Findings: Between June 27, 2022 and February 2, 2024, 30 patients were enrolled; they were followed up for a median duration of 16.2 months (range, 1.5-19.3). In 29 evaluable patients, 22 (75.9%) had Langerhans cell histiocytosis, 3 (10.3%) had Erdheim-Chester disease, and 4 (13.8%) had other subtypes. Most (86.2%) patients had previously received systemic therapy and 27.6% had received ≥3 lines. With a median follow-up of 16.2 months, the ORR was 82.8% (95% CI, 64.2-94.2), with a median time to response of 2.9 months (range, 2.6-6.0) and median duration of response not reached. The 12-month progression-free survival rate was 74.4% (95% CI, 49.8-88.2). Grade ≥3 treatment-emergent adverse events occurred in 13 (43.3%) patients, with folliculitis (10.0%), hypertriglyceridemia (10.0%), and blood creatine phosphokinase increased (6.7%) occurring in more than one patient. No treatment-emergent adverse events led to treatment discontinuation.

Interpretation: Luvometinib demonstrated high and durable responses and a manageable safety profile in patients with histiocytic neoplasms.

Funding: Shanghai Fosun Pharmaceutical Industrial Development Co., Ltd.

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来源期刊
EClinicalMedicine
EClinicalMedicine Medicine-Medicine (all)
CiteScore
18.90
自引率
1.30%
发文量
506
审稿时长
22 days
期刊介绍: eClinicalMedicine is a gold open-access clinical journal designed to support frontline health professionals in addressing the complex and rapid health transitions affecting societies globally. The journal aims to assist practitioners in overcoming healthcare challenges across diverse communities, spanning diagnosis, treatment, prevention, and health promotion. Integrating disciplines from various specialties and life stages, it seeks to enhance health systems as fundamental institutions within societies. With a forward-thinking approach, eClinicalMedicine aims to redefine the future of healthcare.
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