新辅助剂PD-1/PD-L1轴阻塞用于头部和部状细胞癌患者
Shuang Huang1, Chuang Xiong2, Kui Tan3
1Department of Stomatology, The Affiliated Shapingba Hospital of Chongqing University, Chongqing, China.
American journal of otolaryngology
|July 13, 2023
概括
新辅助药物PD-1/PD-L1阻断显示出对头癌的潜力,特别是与化疗或放射治疗相结合. 病理完整反应和主要病理反应是长期结果的关键早期指标.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 癌症研究 癌症研究
背景情况:
- 头部和部状细胞癌 (HNSCC) 通常呈现在局部晚期,需要有效的新辅助疗法.
- 传统的新辅助治疗HNSCC的疗效有限,并与严重的并发症有关.
- 在先进的HNSCC中PD-1/PD-L1轴阻塞的成功表明了新辅助剂应用的潜力.
研究的目的:
- 评估新辅助PD-1/PD-L1轴阻塞在头部和部状细胞癌中的疗效和潜力.
- 评估PD-1/PD-L1阻塞与化疗或放射治疗的组合策略.
- 探索病理反应指标的预后价值.
主要方法:
- 对研究新辅助剂PD-1/PD-L1轴阻塞在HNSCC中的研究进行系统审查和元分析.
- 对不同治疗组合的整体响应率 (ORR),病理完整响应 (pCR) 和主要病理响应 (MPR) 的分析.
- 评估PCR/MPR与患者长期预后之间的相关性.
主要成果:
- 结合PD-1/PD-L1阻塞和化疗或放射治疗的组合显示出显著的疗效,ORR分别在45.0%至96.7%和47.6%至56.7%之间.
- 在不同的疗法中,病理完整反应率差异很大 (16.7%-100.0%),主要病理反应率也很大 (26.9%-100.0%).
- 由于结果不确定,PD-1/PD-L1阻塞与CTLA-4阻塞的结合需要进一步调查.
- 确定pCR和MPR是长期预后的可靠早期预测因素.
结论:
- 新辅助药物PD-1/PD-L1轴阻塞,特别是与化疗或放射治疗相结合,代表了局部发达HNSCC的有前途的治疗策略.
- 病理完整反应和主要病理反应是预测HNSCC患者长期结果的关键早期生物标志物.
- 未来的研究应该专注于优化新辅助PD-1/PD-L1阻断策略,并探索新的组合疗法.
相关概念视频
01:28Chemotherapy-Induced Nausea and Vomiting: Neurokinin-1 Receptor Antagonists
204
Neurokinin 1 (NK1) receptors are distributed across the GI tract, vagal afferents, and key CNS regions including the central vomiting center and chemoreceptor trigger zone (CTZ) Chemotherapy agents stimulate enterochromaffin cells in the gastrointestinal (GI) tract to release large amounts of substance P (SP). SP is a neuropeptide released by specific sensory nerves in response to many different stressors, including those in the GI mucosa affected by chemotherapy. SP binds and activates...
204
02:57Targeted Cancer Therapies
7.7K
The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against...
There are several types of targeted therapies against...
7.7K
01:27Tumor Immunotherapy
567
Immunotherapy is a treatment that boosts or manipulates the immune system to fight diseases, including cancer. For instance, by stimulating an immune response through vaccinations against viruses that cause cancers, like hepatitis B virus and human papillomavirus, these diseases can be prevented. Nonetheless, some cancer cells can avoid the immune system due to their rapid mutation and division. The immune response to many cancers involves three phases: elimination, equilibrium, and escape.
567
02:56Treatment Resistant Cancers
3.3K
Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
3.3K
01:27Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists
249
5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
249