帕博利珠单抗联合二甲双胍治疗转移性头颈部癌的 II 期可行性研究
A Phase II Feasibility Study Combining Pembrolizumab and Metformin in Patients with Metastatic Head and Neck Cancer.
二甲双胍联合帕博利珠单抗耐受性良好,仅出现轻度胃肠道不良事件,并展现出有前景的活性,值得在随机试验中进一步研究。
英文原题:Repeated Mesenchymal Stem Cell Therapy for Radiation-Induced Hyposalivation and Xerostomia in Head and Neck Cancer Survivors
这是一项 II 期注册临床试验,评估异体间充质干细胞治疗相关疾病的安全性、可行性及初步疗效。当前状态:尚未开始招募。计划入组 100 例。登记号:NCT07290946。
不限性别 · ≥ 18 Years
纳入标准: 1. 既往因鼻窦、喉、咽或口腔鳞状细胞癌或腺癌接受放疗。 2. WHO体能状态评分0–1。 3. 每日出现口干。 4. 非刺激性全唾液流率(UWS)0.05–0.5 mL/min。 5. 年龄>18岁。 6. 签署知情同意。 7. 上述癌症完成治疗后随访0.5年,且无复发。 排除标准: 1. 任何其他恶性肿瘤诊断,头颈部癌症除外。 2. 入组时使用致口干药物。 3. 经医务人员评估对青霉素或链霉素过敏。 4. 既往或当前存在其他唾液腺疾病(如干燥综合征、唾液腺结石)。 5. 既往接受颌下腺手术或活检。 6. 妊娠,或计划在第二次治疗后4个月内妊娠。 7. 哺乳。 8. 过去6个月内吸烟。 9. 过去6个月内有酒精滥用(按丹麦国家卫生委员会酒精指南,每周饮酒不得超过10单位)。
Inclusion Criteria: 1. Former radiotherapy for squamous cell carcinoma, or adenocarcinoma, of the nasal sinus, larynx, pharynx, and oral cavity 2. WHO Performance status 0-1 3. Presence of xerostomia daily 4. UWS of 0.05 mL/min to 0.5 ml/min 5. Age above 18 6. Informed consent 7. 0.5 year follow-up of the cancers in 1. with no recurrence Exclusion Criteria: 1. Any malignant cancer diagnosis excluding head and neck cancers 2. Xerogenic medications at inclusion 3. Penicillin or streptomycin allergy assessed by health personnel 4. Any other previous or active disease of the salivary glands (e.g. Sjögren's Disease, sialolothiasis) 5. Previous submandibular surgery or biopsy 6. Pregnancy or planned pregnancy until 4 months after second treatment 7. Breastfeeding 8. Smoking within the last 6 months 9. Alcohol abuse within the last 6 months (consumption must not be above 10 units/week (Danish National board health alcohol guidelines)
以上为辅助阅读译文。是否适合入组须由主治医生判断,最终以登记平台与研究者确认为准。
主要终点:Unstimulated whole salivary flow rate · Unstimulated whole salivary flow rate measured in mL/min · T=0 months, T=4 months and T=8 months (primary endpoint assessed after 8 months)
次要终点:Stimulated whole salivary flow rate;Patient-Reported Outcome of xerostomia: The Groningen Radiotherapy-Induced Xerostomia questionnaire (GRIX).;Patient-Reported Outcome of xerostomia: The European organization for research and treatment of cancer quality of life questionnaire, head and neck-35 (EORTC QLQ-H&N35).;Immune response;Patient Reported Outcome: Goal Attainment Scale (GAS)
将异基因脂肪来源间充质干细胞注射至双侧颌下腺内治疗。
向双侧颌下腺内注射无菌等渗生理盐水。
口干会导致全天持续且令人衰弱的症状。口干的两个主要原因是干燥综合征和头颈癌放疗后的不良反应。既往临床试验已研究间充质干细胞治疗口干,并取得令人鼓舞的结果;但仅少数参加者的唾液流率恢复正常。因此,本随机临床试验将在间隔4个月后给予两次间充质干细胞治疗,此前尚未采用过这种方案。 研究假设:两次间充质干细胞治疗可提高唾液流率并改善口干症状。
Dry mouth leads to debilitating symptoms 24/7. The two primary causes for dry mouth are Sjögrens disease and after radiotherapy of a head and neck cancer. Former clinical trials have investigated mesenchymal stem cell treatment for dry mouth with promising results. However, few of the participants evolved normal salivary flow rate. Therefore, in this randomized clinical trial, two treatments of mesenchymal stem cells are administered, 4 months apart. This has not been done before. The hypothesis is that two treatments of mesenchymal stem cells results in a higher salivary flow rate and ameliorate symptoms from dry mouth.
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