70岁以上肺癌患者单独或与化疗一起使用 pembrolizumab:回顾性研究
Miriam Blasi1, Jonas Kuon2, Rajiv Shah2
1Department of Thoracic Oncology, Thoraxklinik and National Center for Tumor Diseases at Heidelberg University Hospital, Heidelberg, Germany.
Clinical lung cancer
|June 30, 2023
概括
对于老年非小细胞肺癌 (NSCLC) 患者来说,化疗免疫疗法对布罗利祖马布单一治疗没有生存益处,但会增加不良事件. 预后不良的因素包括ECOG PS2,大脑转移,状组织学和PD-L1负面性.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 肺癌研究研究 肺癌研究
背景情况:
- 对老年非小细胞肺癌 (NSCLC) 患者的第一线治疗的证据有限.
- 布罗利祖马布已批准用于PD-L1≥50%的NSCLC或与化疗结合治疗.
- 老年NSCLC患者代表了一个脆弱的人群,有着独特的治疗考虑.
研究的目的:
- 分析一线 pembrolizumab 单疗法与 pembrolizumab 加上化疗在患有NSCLC的70岁或以上的患者中的疗效和安全性.
- 确定影响该特定患者队列结果的预后因素.
主要方法:
- 在2016年1月至2021年5月期间连续治疗的156名70岁以上患者的回顾性分析.
- 通过放射学审查和医疗记录中的毒性评估瘤进展.
- 在 pembrolizumab 单一疗法和 pembrolizumab 加化学疗法组之间的结局的比较.
主要成果:
- 与单独治疗 (61名患者) 相比, pembrolizumab加化学疗法 (95名患者) 的不良事件发生率 (91%对51%),治疗中止 (37%对21%) 和住院 (56%对23%) 较高.
- 无进展生存期 (PFS) 和整体生存期 (OS) 在各组之间相似 (PFS 中位数为7个月与8个月;OS 中位数为16个月与14个月).
- 与免疫相关的不良事件 (irAEs) 的发生率相似 (35%在两组中),它们的发生与更长的生存时间有关 (PFS中位数为11个月与5个月;OS中位数为33个月与10个月).
- 更糟糕的ECOG性能状态 (PS) ≥2,大脑转移,状组织学和PD-L1表达的缺乏是较短的PFS和OS的独立预测因素.
结论:
- 在老年NSCLC患者中,化学免疫疗法增加了不良事件和住院治疗,但没有改善PFS或OS,而不是 pembrolizumab单一治疗.
- 特定的临床因素,如不良的ECOGPS,大脑转移,状组织学和PD-L1负面性,与这一群体的不良结果有关.
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