固体瘤中的超渐进性疾病 (HPD) 在现实世界中接受免疫检查点抑制剂
Yada Kanjanapan1,2, Geetha Guduguntla3, Ashwati Krishnan Varikara4
1Department of Medical Oncology, The Canberra Hospital, Canberra, Australia.
Technology in cancer research & treatment
|October 27, 2023
概括
超渐进性疾病 (HPD) 发生在接受癌症免疫治疗的13%患者中,表明瘤生长加速. 肝转移,而不是TIL或PD-L1状态,与HPD风险和生存结果有关.
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:
- 超渐进性疾病 (HPD) 是癌症免疫治疗的严重并发症,其特征是瘤生长加速和预后不佳.
- HPD的发病率各不相同 (6-29%),没有确立的预测生物标志物.
- 瘤透淋巴细胞 (TIL) 在免疫疗法中具有预后价值,但它们在HPD中的作用未得到充分研究.
研究的目的:
- 为了确定HPD在实体瘤患者的患病率,在现实环境中用免疫检查点抑制剂 (ICI) 治疗.
- 确定临床病理特征,包括TIL和PD-L1状态,作为HPD的潜在生物标志物.
- 评估HPD与整体存活率之间的关联.
主要方法:
- 用ICI治疗的固体瘤患者的回顾性分析.
- 在固体瘤中使用响应评估标准 (RECIST) 标准对HPD的评估.
- 从档案瘤样本中,HPD与临床病理因素的相关性,包括TIL和PD-L1状态.
主要成果:
- 在13%的患者中观察到HPD (11/87),与明显较低的整体存活率 (5.5与18.3个月相比) 相关.
- 多变量分析确定肝转移 (HR 4.66) 和PD-L1状态 (HR 0.53) 是显著的生存预测因素.
- 肝转移与HPD发生相关 (P=.01),而年龄,性别,免疫治疗类型,TIL和PD-L1状态并不能预测HPD.
结论:
- 这项研究证实,在现实世界接受ICI治疗的患者中,HPD的患病率为13%,与之前的报告一致.
- 在临床试验之外,使用定义的成像标准进行HPD评估是可行的.
- 肝转移与HPD风险有关,而TILs和PD-L1状态在这个队列中不能预测HPD.
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