免疫治疗的持续时间与高级非小细胞肺癌的整体存活率之间的关联
Lova Sun1, Benjamin Bleiberg1, Wei-Ting Hwang2
1Division of Hematology and Oncology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
JAMA oncology
|June 4, 2023
概括
对于接受免疫治疗的高级非小细胞肺癌 (NSCLC) 患者,在2年后停止治疗,与继续治疗相比,整体存活率没有显著差异. 这一发现使临床医生和考虑停止治疗的患者放心.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 临床研究 临床研究
背景情况:
- 对于晚期非小细胞肺癌 (NSCLC) 免疫检查点抑制剂 (ICI) 治疗的最佳持续时间仍未确定.
- 基于前线免疫治疗的治疗方法对于晚期NSCLC是常见的,但治疗持续时间的策略有所不同.
研究的目的:
- 分析ICI治疗停止2年后的实践模式.
- 为了比较固定的持续时间 (2年) 和无限期ICI治疗的患者之间的整体存活率.
主要方法:
- 先进NSCLC患者 (2016-2020) 的回顾性,基于人群的队列研究.
- 使用卡普兰-梅尔方法和多变量考克斯回归分析760天的整体存活率.
- 在两年内停止ICI治疗的患者与在两年后继续治疗的患者的比较.
主要成果:
- 在1091名患者中,在2年内没有进展,113人接受了固定的持续时间和593人接受了无限期的ICI治疗.
- 从760天开始的两年总生存率为79% (固定) 和81% (无限).
- 两组之间没有观察到总生存时间的统计学上显著差异 (aHR,1.33;P=.29).
结论:
- 大约五分之一的晚期NSCLC患者在两年内停止了ICI治疗,没有进展.
- 在2年后停止ICI治疗是一种可行的选择,对没有进展的患者的整体存活率没有重大影响.
- 这些发现支持在高级NSCLC中关于ICI治疗持续时间的共享决策.
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