免疫检查点抑制剂在非小细胞肺癌中 - - 什么时候我们应该敢于停止治疗?
Farastuk Bozorgmehr1, Annette Müller2, Justyna Rawluk3
1Thoraxklinik and National Center for Tumor Diseases, Heidelberg University Hospital, Röntgenstr. 1, 69115 Heidelberg, Germany and German Center for Lung Research (DZL), Germany.
Lung cancer (Amsterdam, Netherlands)
|September 1, 2023
概括
免疫检查点抑制剂 (ICI) 为非小细胞肺癌 (NSCLC) 患者提供长期生存. 在两年后停止ICI可能会维持反应,从而可能降低成本和医疗负担.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
背景情况:
- 免疫检查点抑制剂 (ICI) 已经改变了非小细胞肺癌 (NSCLC) 治疗,在息环境中提供了延长生存时间.
- 高昂的治疗成本和资源利用需要评估治疗持续时间的策略.
研究的目的:
- 审查在NSCLC患者两年治疗后停止ICI的数据.
- 为了告知临床决策关于停止ICI治疗的响应患者.
主要方法:
- 临床试验的评估,限制两年ICI治疗持续时间.
- 对完成两年ICI治疗的患者的随访数据的分析.
- 关于在响应NSCLC患者中停止ICI治疗的数据的审查.
主要成果:
- 大约25%的患者完成了为期两年的ICI课程.
- 在这些人中,40-46%的人在没有进一步治疗的情况下在五年内仍然活着,生存率高达83%.
- 关于ICI重试疗法的有效性数据有限,并表明与初始治疗相比,其有效性较低.
结论:
- 在初始反应和为期两年的疗程后停止ICI治疗需要认真考虑.
- 这种方法可以通过维持长期反应,使患者和医疗保健系统受益.
- 需要对预测生物标志物 (例如PD-L1,ctDNA,PET) 进行进一步的研究,以指导治疗决策.
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