III期(INAVO120)结果显示inavolisib联合哌柏西利和氟维司群显著延长一线治疗的无进展生存时间。激素受体(HR)阳性乳腺癌患者中大约40%存在PIK3CA突变,这一突变与肿瘤生长、疾病进展和治疗耐药等相关[1],[2]。数据将在后续的国际学术会议上公布。2023年12月5日,罗氏宣布III期临床试验INAVO120研究取得阳性结果。inavolisib联合哌柏西利和氟维司群,可作为PIK3CA突变的HR阳性、HER2阴性、内分泌耐药的局晚或转移性乳腺癌患者的一线治疗选择。研究达到无进展生存期(PFS)的主要终点,与单用哌柏西利和氟维司群相比,inavolisib联合治疗组显示出有统计学意义和临床意义的显著延长。虽然总体生存期(OS)数据尚不成熟,但已观察到明显的积极趋势,后续将继续进行下一次分析。Levi Garraway博士罗氏首席医学官兼全球药品开发负责人对于PIK3CA突变的HR阳性乳腺癌患者,inavolisib联合治疗的关键性研究结果代表着变革性的医疗进步。我们期待将乳腺癌药物产品组合扩展到HR阳性领域,并尽快为患者提供这一潜在创新治疗方案。inavolisib联合治疗耐受性良好,不良反应与已知安全性特征一致,未观察到新的安全信号。inavolisib是一种口服药物,高选择性抑制PI3Κα并且能特异性降解PI3Κα突变蛋白。凭借这种独特的双重作用机制,inavolisib可以为PIK3CA突变的HR阳性/HER2阴性晚期乳腺癌患者提供良好的耐受性、持久的疾病控制并可能改善预后。PIK3CA突变可导致PI3Κα蛋白改变,从而导致肿瘤生长失控、疾病进展和对内分泌治疗耐药。[3],[4]目前,inavolisib开展了三项III期临床研究(INAVO120、INAVO121、INAVO122),在PIK3CA突变的转移性乳腺癌患者中以不同的联合方案进行。关于INAVO120研究[5]INAVO120研究[NCT04191499]是一项在PIK3CA突变、激素受体阳性、HER2阴性局部晚期或转移性乳腺癌患者中评价inavolisib联合哌柏西利和氟维司群对比安慰剂联合哌柏西利和氟维司群治疗有效性和安全性的III期、随机、双盲、安慰剂对照研究,患者在辅助内分泌治疗期间或治疗完成后12个月内发生疾病进展,且既往针对转移性疾病未接受过系统治疗。研究入组325例患者,随机分配到研究组或对照组治疗。主要终点是研究者评估的无进展生存期,定义是随机至疾病进展或由于任何原因死亡的时间。次要终点包括总生存期、客观缓解率和临床获益率。关于inavolisibinavolisib是一种创新口服靶向治疗药物,能为HR阳性、PIK3CA突变的乳腺癌患者提供良好的耐受性、持久的疾病控制并有可能改善预后。PIK3CA突变率约40%,在乳腺癌患者较常见但常常被忽视。[1]inavolisib设计用于降低治疗的总体毒性,有别于其他的PI3K抑制剂,它在体外对PI3Kα的抑制有高效力和特异性,同时有独特的作用机制可降解PI3Kα突变体。[4]inavolisib目前在PIK3CA突变局部晚期或转移性乳腺癌中开展了3项III期临床研究:联合哌柏西利和氟维司群vs.哌柏西利和氟维司群一线治疗HR阳性/HER2阴性乳腺癌患者(INAVO120)[5]联合氟维司群vs.alpelisib联合氟维司群治疗CDK4/6抑制剂联合内分泌经治的HR阳性/HER2阴性乳腺癌患者(INAVO121)[6]联合帕妥珠曲妥珠单抗注射液(皮下注射)(Phesgo®)vs.Phesgo作为一线 HER2阳性乳腺癌维持治疗(INAVO122)[7]参考文献:[1] André F, et al. Alpelisib for PIK3CA-Mutated, Hormone Receptor-Positive Advanced Breast Cancer. N Engl J Med. 2019;380(20):1929-40[2] He Y, et al. Targeting PI3K/Akt signal transduction for cancer therapy. Signals Transduction and Targeted Therapy. 2021; 6: 425[3] Juric et al. A phase I/Ib study of inavolisib (GDC-0077) in combination with fulvestrant in patients (pts) with PIK3CA-mutated hormone receptor-positive/HER2-negative (HR+/HER2–) metastatic breast cancer. Presented at San Antonio Breast Cancer Symposium, 2020 December 7-10; San Antonio, USA. Abstract #P5-17-05[4] Hong R., et al. GDC-0077 is a selective PI3K alpha inhibitor that demonstrates robust efficacy in PIK3CA mutant breast cancer models as a single agent and in combination with standard of care therapies. Cancer Res. 2018;78(4):4-14. https://doi.org/10.1158/1538-7445.SABCS17-PD4-14[5] ClinicalTrials.gov. A Study Evaluating the Efficacy and Safety of Inavolisib + Palbociclib + Fulvestrant vs Placebo + Palbociclib + Fulvestrant in Patients With PIK3CA-Mutant, Hormone Receptor-Positive, Her2-Negative, Locally Advanced or Metastatic Breast Cancer (INAVO120) [Internet; cited 2023 December] Available from: https://classic.clinicaltrials.gov/ct2/show/NCT04191499[6] ClinicalTrials.gov. A Study Evaluating the Efficacy and Safety of Inavolisib Plus Fulvestrant Compared With Alpelisib Plus Fulvestrant in Participants With HR-Positive, HER2-Negative, PIK3CA Mutated, Locally Advanced or Metastatic Breast Cancer Post CDK4/6i and Endocrine Combination Therapy (INAVO121) [Internet; cited 2023 December] Available from: https://classic.clinicaltrials.gov/ct2/show/NCT05646862[7] ClinicalTrials.gov. A Study to Evaluate the Efficacy and Safety of Inavolisib in Combination With Phesgo Versus Placebo in Combination With Phesgo in Participants With PIK3CA-Mutated HER2-Positive Locally Advanced or Metastatic Breast Cancer [Internet; cited 2023 December] Available from: https://clinicaltrials.gov/study/NCT05894239?term=WO44263&rank=11. 本新闻稿旨在分享研发前沿资讯,仅供中国境内医疗卫生专业人士参阅,非广告用途。2. 罗氏不推荐任何未被批准的药品、适应症的使用。罗氏制药中国官方视频号长按并识别二维码关注我视频号