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Korean Cancer Study Group 
Webzine Vol.31  MAR 2024 
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KCSG ์—ฐ๊ตฌ ๋…ผ๋ฌธ ์†Œ๊ฐœ

โ–ถ KCSG HN15-16
A Phase II Trial of Nintedanib in Patients with Metastatic or Recurrent Head and Neck Squamous Cell Carcinoma (HNSCC): In-Depth Analysis of Nintendanib Arm from the KCSG HN 15-16 TRIUMPH Trial.

์ €๋„: Cancer Res Treat. 2023 Jul 20. Online ahead of print.

 

์ œ1์ €์ž ์ž„์„ ๋ฏผ (์—ฐ์„ธ์•”๋ณ‘์›) 

 

Q. ์—ฐ๊ตฌ์˜ ๋ฐฐ๊ฒฝ์€?

์žฌ๋ฐœ์„ฑ, ์ „์ด์„ฑ ๋‘๊ฒฝ๋ถ€ ํŽธํ‰์„ธํฌ์•”์€ ํ‘œ์ ์น˜๋ฃŒ์ œ ์‚ฌ์šฉ์ด ์–ด๋ ค์šด ์น˜๋ฃŒํ•˜๊ธฐ ์–ด๋ ค์šด ์•”์— ์†ํ•ฉ๋‹ˆ๋‹ค. TRIUMPH ์—ฐ๊ตฌ๋Š” ๋งˆ๋•…ํ•œ ํ•ญ์•”์น˜๋ฃŒ์ œ๊ฐ€ ๋ณ„๋กœ ์—†๋Š” ๋‚œ์น˜์„ฑ ๋‘๊ฒฝ๋ถ€์•” ํ™˜์ž๋“ค์„ ์œ„ํ•ด ๊ธฐํš๋˜์—ˆ๊ณ  ๋ณธ ์—ฐ๊ตฌ๋Š” ๊ทธ ์ค‘์— FGFR ์œ ์ „์ž ๊ฒฝ๋กœ์˜ ๋Œ์—ฐ๋ณ€์ด๋ฅผ ๊ฐ€์ง„ ํ™˜์ž๋“ค์„ ๋Œ€์ƒ์œผ๋กœ ํ•œ ๋‹จ์ผ๊ตฐ, 2์ƒ ์ž„์ƒ ์—ฐ๊ตฌ์ž…๋‹ˆ๋‹ค.


Q. ์—ฐ๊ตฌ์˜ ๋ชฉ์ ์€?

๋ณธ ์—ฐ๊ตฌ์—์„œ๋Š” FGFR ๊ฒฝ๋กœ์˜ ์œ ์ „์ž ๋Œ์—ฐ๋ณ€์ด๋ฅผ ๊ฐ€์ง„ ํ™˜์ž๋ฅผ ๋Œ€์ƒ์œผ๋กœ FGFR ์–ต์ œ์ œ์ธ Nintedanib ๋‹จ์ผ ์šฉ๋ฒ•์˜ ํšจ๊ณผ์™€ ์•ˆ์ „์„ฑ์„ ๊ฒ€์ฆํ•˜๊ธฐ ์œ„ํ•œ 2์ƒ ์ž„์ƒ ์‹œํ—˜์œผ๋กœ ์ง„ํ–‰ ๋˜์—ˆ๊ณ , TRIUMPH ์—ฐ๊ตฌ์˜ 5๊ฐœ์˜ ์น˜๋ฃŒ๊ตฐ ์ค‘ ํ•˜๋‚˜์— ์†ํ•˜๋Š” ๊ฒƒ์ด์—ˆ์Šต๋‹ˆ๋‹ค. 


Q. ์—ฐ๊ตฌ ๋ฐฉ๋ฒ•?

TRIUMPH ์—ฐ๊ตฌ๋Š” ๋ฐฑ๊ธˆ ๊ธฐ๋ฐ˜ ํ•ญ์•”์น˜๋ฃŒ์— ์‹คํŒจํ•œ ์ „์ด์„ฑ ์žฌ๋ฐœ์„ฑ ๋‘๊ฒฝ๋ถ€ ํŽธํ‰์„ธํฌ์•” ํ™˜์ž๋ฅผ ๋Œ€์ƒ์œผ๋กœ ์ง„ํ–‰๋œ ์ตœ์ดˆ์˜ ์œ ์ „์ž ๊ธฐ๋ฐ˜์˜ ์šฐ์‚ฐํ˜• ์ž„์ƒ์‹œํ—˜์ž…๋‹ˆ๋‹ค. ์šฐ์‚ฐํ˜• ์ž„์ƒ์‹œํ—˜์€ ์œ ์ „์ž ๊ธฐ๋ฐ˜์˜ ํ‘œ์ ํ•ญ์•”์น˜๋ฃŒ๋ฅผ ๋™์‹œ์— ํ•˜๋Š” ์ƒˆ๋กœ์šด ํ˜•ํƒœ์˜ ์ž„์ƒ์‹œํ—˜์œผ๋กœ, ์—ฐ๊ตฌ์ง„์€ ์ฐจ์„ธ๋Œ€ ์—ผ๊ธฐ์„œ์—ด ๋ถ„์„์„ ํ†ตํ•ด ์•”์œ ์ „์ž ๋ณ€์ด๋ฅผ ๋ถ„์„ํ•˜๊ณ , ๋ถ„์ž์ข…์–‘์œ„์›ํšŒ(Molecular Tumor Board)๋ฅผ ํ†ตํ•ด ํ•ด๋‹น ๋ณ€์ด์— ์ ํ•ฉํ•œ ๋งž์ถคํ˜• ํ‘œ์ ์น˜๋ฃŒ์ œ๋ฅผ ๋ฐฐ์ •ํ•ด ํ™˜์ž๋ฅผ ์น˜๋ฃŒํ–ˆ์Šต๋‹ˆ๋‹ค. 2017๋…„ 10์›”์—์„œ 2020๋…„ 8์›”๊นŒ์ง€ ๊ตญ๋‚ด์—์„œ 180๋ช…์˜ ์ „์ด์„ฑ ๋‘๊ฒฝ๋ถ€์•” ํ™˜์ž๊ฐ€ ๋“ฑ๋ก๋๊ณ , ์œ ์ „์ž ์œ ํ˜•์— ๋”ฐ๋ผ 5๊ฐœ์˜ ์น˜๋ฃŒ๊ตฐ์— ๋ฐฐ์ •๋˜์–ด ์น˜๋ฃŒ๋ฅผ ๋ฐ›์•˜์Šต๋‹ˆ๋‹ค.โ€ฏ๊ทธ ์ค‘ FGFR ์œ ์ „์ž ๋ณ€์ด ๊ตฐ์€ Nintedanib ๊ตฐ์— ๋ฐฐ์ •์ด ๋˜์–ด ์น˜๋ฃŒ ๋ฐ›์•˜์Šต๋‹ˆ๋‹ค.


Q. ์—ฐ๊ตฌ ๊ฒฐ๊ณผ?

2017๋…„๋ถ€ํ„ฐ 2020๋…„๊นŒ์ง€, ์ด 8๋ช…์˜ ํ™˜์ž๊ฐ€ Nintedanib ๊ตฐ์— ๋ฐฐ์ •์ด ๋˜์—ˆ์œผ๋ฉฐ ์น˜๋ฃŒ ๋ฐ›์•˜์Šต๋‹ˆ๋‹ค. ๊ฐ๊ด€์  ๋ฐ˜์‘๋ฅ ์€ 42.9%, ์งˆ๋ณ‘ ์กฐ์ ˆ๋ฅ ์€ 57.1% ์˜€์œผ๋ฉฐ, ๋ฌด์ง„ํ–‰ ์ƒ์กด๊ธฐ๊ฐ„์€ 5.6๊ฐœ์›”์ด์—ˆ๊ณ , ๋ฐ˜์‘ ์ง€์† ๊ธฐ๊ฐ„์€ 9.1 ๊ฐœ์›”์ด์—ˆ์Šต๋‹ˆ๋‹ค. ํ•œ ๋ช…์˜ ํ™˜์ž๋Š” 36๊ฐœ์›” ์ด์ƒ ๋ถ€๋ถ„ ๋ฐ˜์‘์„ ๋ณด์˜€๊ณ , ์ „๋ฐ˜์ ์œผ๋กœ ๋…์„ฑ์€ ๊ฒฝ๋ฏธํ•˜์˜€์Šต๋‹ˆ๋‹ค. ๋น„๋ก ์ ์€ ์ˆ˜์˜ ํ™˜์ž์ด์ง€๋งŒ, ๋ถ€๋ถ„ ๋ฐ˜์‘์— ๋„๋‹ฌํ•œ ํ™˜์ž๋“ค์ด ์žˆ์—ˆ๋‹ค๋Š” ์ , ๋˜ ํ•œ ๋ช…์˜ ํ™˜์ž์—์„œ ๊ฑฐ์˜ ์™„์ „ ๋ฐ˜์‘์— ๊ฐ€๊นŒ์šด ์šฐ์ˆ˜ํ•œ ๊ฒฐ๊ณผ๊ฐ€ ์žˆ์—ˆ๋‹ค๋Š” ์ ์ด ์ฃผ๋ชฉํ•  ๋งŒํ•ฉ๋‹ˆ๋‹ค.


Q. ๋งˆ์ง€๋ง‰์œผ๋กœ ํ•˜๊ณ  ์‹ถ์€ ๋ง์€?

๋งˆ์ง€๋ง‰์œผ๋กœ ๋ณธ ์—ฐ๊ตฌ์˜ ์ด๊ด„ ์ฑ…์ž„์ž์ด์‹  ์œคํ™˜์ค‘ ๊ต์ˆ˜๋‹˜, ์—ฐ๊ตฌ ์‹ค๋ฌด๋ฅผ ํ•จ๊ป˜ ๋„์™€์ฃผ์‹  ๊น€ํ˜œ๋ จ ๊ต์ˆ˜๋‹˜, ๊น€๋ฒ”์„ ๊ต์ˆ˜๋‹˜, ๊ทธ๋ฆฌ๊ณ  Nintedanib ๊ตฐ์˜ ์ฑ…์ž„์ž์ด์‹  ๊น€์ง„์ˆ˜ ๊ต์ˆ˜๋‹˜๊ป˜ ๊ฐ์‚ฌ๋ฅผ ๋“œ๋ฆฌ๋ฉฐ, ๋ณธ ์—ฐ๊ตฌ๋ฅผ ํ†ตํ•ด ์น˜๋ฃŒ ์•ฝ์ œ๊ฐ€ ํฌ๋ฐ•ํ•œ ์ „์ด์„ฑ ๋‘๊ฒฝ๋ถ€์•” ํ™˜์ž๋“ค์—๊ฒŒ ๋” ๋‚˜์€ ์น˜๋ฃŒ๊ฐ€ ์ œ๊ณต ๋˜์—ˆ๊ธฐ๋ฅผ ๋ฐ”๋ž๋‹ˆ๋‹ค.