基于PD-1抑制剂的二线疗法用于转移性胃癌
Miaomiao Gou1, Yong Zhang2, Zhikuan Wang1
1Medical Oncology Department, The Fifth Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China.
对于在一线治疗中进展的转移性胃癌患者来说,PD-1抑制剂组合治疗显示出作为二线选择的希望. 将PD-1抑制剂与化疗和抗血管原体药物结合使用改善了结果,并且耐受性良好.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 胃肠道瘤学 胃肠道瘤学
背景情况:
- 转移性胃癌 (MGC) 患者在一线治疗失败后,通常在标准化疗中表现不佳.
- 布罗利祖马布 (PD-1 抑制剂) 在二线MGC治疗的KEYNOTE-061研究中没有显示出对帕克利塔塞尔的优势.
- 需要探索MGC的替代和有效的二线治疗策略.
研究的目的:
- 评估基于PD-1抑制剂的治疗方法的疗效和安全性,作为MGC的二线治疗.
- 确定与接受二线PD-1抑制剂治疗的MGC患者的良好结果相关的临床特征.
主要方法:
- 对129名MGC患者进行了回顾性观察性研究,这些患者接受了基于抗PD-1的治疗,作为二线治疗.
- 治疗疗效 (客观反应率,疾病控制率) 和安全性 (与治疗相关的不良事件) 的初级评估.
- 单变量和多变量分析以将临床特征与无进展生存期 (PFS) 和总生存期 (OS) 相关联.
主要成果:
- 总体客观应答率 (ORR) 为16.3%,疾病控制率 (DCR) 为79.1%.
- 与PD-1抑制剂,化疗和抗血管原剂的联合治疗产生了更高的ORR (19.6%) 和DCR (94.1%).
- 中位数PFS为4.10个月,中位数OS为7.60个月. 之前的抗PD-1病史和组合治疗是PFS和OS的独立预后生物标志物.
结论:
- PD-1 抑制剂与化疗和抗血管原剂相结合,可能改善二线MGC治疗中的临床活性.
- 以前的PD-1治疗史似乎是改善结果的重要因素.
- 这些组合疗法显示出可接受的安全性概况,因此需要在更大的多中心研究中进行进一步调查.
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