尼沃卢马布加上伊皮利穆马布治疗晚期唾液腺癌:第二阶段试验
Joris L Vos1, Bharat Burman2, Swati Jain1
1Head and Neck Service and Immunogenomic Oncology Platform, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Nature medicine
|August 24, 2023
概括
尼沃卢马布和伊皮利穆马布在转移性腺囊性癌症中表现出有限的疗效,但可能有利于其他唾液腺癌,特别是唾液管癌. 组合疗法在非ACCSGC中显示出潜力,需要进一步调查.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 基因组学就是基因组学.
背景情况:
- 转移性唾液腺癌 (SGCs) 很罕见,具有攻击性,缺乏有效的治疗方法.
- 使用检查点抑制剂的免疫治疗为先进的SGC提供了潜在的治疗途径.
研究的目的:
- 评估nivolumab (抗PD-1) 加上ipilimumab (抗CTLA-4) 在转移性SGC患者的疗效和安全性.
- 探索SGCs响应组合免疫疗法的免疫基因组景观.
主要方法:
- 一项2期临床试验,涉及64名转移性SGC患者,分为腺状囊性癌 (ACC) 和其他SGC队列.
- 对治疗前和治疗期间的样本进行全面的基因组 (全外体,RNA,TCR测序) 和流细胞计分析.
- 对客观反应率 (ORR) 和无进展生存率 (PFS) 的评估.
主要成果:
- 主要疗效终点在非ACC SGC队列 (16%的ORR) 中实现,但在ACC队列 (6%的ORR) 中没有实现.
- 与治疗相关的≥3级不良事件发生在38%的患者中.
- 在ACC中,PFS中位数为4.4个月,在其他SGC中为2.2个月.
- 响应的瘤显示T细胞克隆扩张和突变收缩;响应的ACCs具有诱导T细胞反应的新抗原.
结论:
- 尼沃卢马布加上伊皮利穆马布在转移性ACC中表现出有限的疗效,但对其他SGC,特别是唾液管癌,显示出有前途.
- 免疫基因组分析提供了对SGC免疫疗法的反应机制和潜在生物标志物的洞察力.
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