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在第三阶段黑色素瘤中辅助免疫治疗的时间,是否重要?

Kristen E Rhodin¹, Sin-Ho Jung², Kelly Elleson³

¹Department of Surgery, Duke University, Durham, NC, USA. kristen.rhodin@duke.edu.

Annals of surgical oncology

|July 22, 2023

概括

在第三阶段黑色素瘤切除后超过六周,开始使用辅助免疫检查点抑制剂 (ICI) 可能会改善无复发生存率 (RFS). 在这项研究中,在六周内早期开始ICI与更糟糕的RFS有关.

科学领域:

在瘤学瘤学.
免疫学免疫学免疫学
临床研究临床研究

背景情况:

黑色素瘤切除后辅助免疫检查点抑制剂 (ICI) 的最佳时间尚不清楚.
辅助免疫疗法是切除的III期黑色素瘤的标准治疗方法.

研究的目的:

调查手术和辅助免疫检查点抑制剂 (ICI) 启动之间的时间间隔对III期黑色素瘤患者的生存结果的影响.

主要方法:

一项多机构的回顾性队列研究,对626名接受辅助免疫治疗的被切除的III期黑色素瘤患者进行了研究.
根据辅助ICI的时间,患者被分为三组:在6周内,6-12周,以及手术后超过12周.
使用Kaplan-Meier和Cox比例危险模型分析了无复发生存 (RFS).

主要成果:

在多变量分析中,在手术后6周以上开始辅助性ICI与改善的RFS有关.
切除后6周内接受ICI治疗的患者与其他组相比,表现较差的RFS.
这些发现在各个子组分析中是一致的,包括新诊断,隐性III期疾病和抗PD-1单疗接受者.

结论:

治疗III期黑色素瘤的辅助免疫检查点抑制剂 (ICI) 可以在切割后6周后开始使用,而不会影响结果.
需要进一步的研究来阐明辅助ICI定时的机制和长期影响.

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