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進行した稀な皮膚がん患者の全身療法の結果: 209人の患者による遡及的多中心 DeCOG 試験
Selma Ugurel1, Nessr Abu Rached2, Thilo Gambichler2
1Department of Dermatology, Bielefeld University, Medical School and University Medical Center OWL, Klinikum Bielefeld Rosenhöhe, Bielefeld, Germany.
まとめ
免疫チェックポイント阻害 (ICI) を含む全身療法では,血管肉腫やカポシ肉腫のような稀な皮膚がんでは様々な結果が得られます. ICIの有効性は,多形性皮膚肉腫と血管肉腫では高いが,皮膚付近性がんでは低い.
科学分野:
- 腫瘍学
- 皮膚科
- 癌 研究
背景:
- 稀な皮膚がんに対する全身療法の結果に関するデータは限られている.
- 免疫チェックポイント阻害 (ICI) は,希少な皮膚がんにおける有効性が不明の主要な全身療法です.
研究 の 目的:
- ICIを含む全身療法の実用的な使用とアウトカムを,進行した稀な皮膚がんで分析する.
- 皮膚アニオサルコマ (AS),カポシ・サルコマ (KS),プレオモルフ皮膚サルコマ (PDS),皮膚副がん (CAC) の治療効果を比較する.
主な方法:
- 進行した非切除可能なAS,KS,PDS,CACの患者209人を対象に実施した多中心治験.
- 整体療法には化学療法とICIが含まれていた.
- 最良の全生存率 (BOR),無進行生存率 (PFS),全生存率 (OS) が評価されました.
主要な成果:
- 化学療法はASとKSで一般的であったが,ICIはPDSとCACでより一般的であった.
- 最良総合反応 (BOR) は,KS (65. 5%),PDS (50. 0%),AS (41. 6%),CAC (10. 8%) と異なった.
- 1年間のPFS率:PDS (70.7%),KS (45.7%),AS (25.6%),CAC (18.5%) でした. 1 年の OS 率: KS (97.3%),AS (84.2%),PDS (67.7%),CAC (65.4%)
結論:
- システム療法タイプと結果は,稀な皮膚がんのエンティティによって著しく異なります.
- 免疫チェックポイント阻害 (ICI) は,PDSとASにおいて高い効果を示し,KSにおいては中等で,CACにおいては低い効果を示した.
- 進行した皮膚副がん (CAC) は,全身療法に関係なく予後が悪い.
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