霍奇金淋巴瘤免疫检查点抑制剂后的进展模式:对放射治疗的影响
Jessica F Burlile1, Kelsey M Frechette1, William G Breen1
1Department of Radiation Oncology, Mayo Clinic, Rochester, MN.
Blood advances
|January 11, 2024
概括
免疫检查点抑制剂 (ICI) 在霍奇金淋巴瘤 (HL) 中表现有前途,但进展模式是关键. 有限疾病患者在ICI期间或之后可能受益于放射治疗,特别是如果进展发生在先前存在的部位.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 辐射疗法 辐射疗法
背景情况:
- 免疫检查点抑制剂 (ICI) 改善了复发性或耐火性霍奇金淋巴瘤 (HL) 的治疗结果.
- 然而,很大一部分患者最终会经历疾病进展.
- 了解进展模式对于优化治疗策略至关重要,包括局部疗法的作用.
研究的目的:
- 用免疫检查点抑制剂 (ICI) 治疗霍奇金淋巴瘤 (HL) 患者的疾病进展模式的描述.
- 确定可能受益于联合治疗方式的患者子组,如放射治疗,在ICI治疗期间或之后.
主要方法:
- 在2013年至2022年期间,90名HL患者接受ICI治疗的回顾性审查.
- 分析Fludeoxyglucose-18正子发射断层扫描 (FDG-PET) 扫描在ICI前和进展时,以映射疾病部位.
- 在ICI之前,通过有限的疾病部位 (≤5) 定义的"可治疗的进展"和仅限于这些部位的进展的探索性分析.
主要成果:
- 在69名具有完整病历的患者中,66.4%在ICI后或之后进展.
- 在ICI前,在所有患者中的39.4%和在有限疾病患者中的34% (≤5个部位) 中,进展仅发生在ICI前的部位.
- 在ICI前,患有5个以上疾病部位的患者患病进展的风险显著增加.
结论:
- 许多接受ICI治疗的HL患者经历了进展,通常是在先前参与的部位.
- 在ICI治疗前疾病负担有限,在原始部位进展的患者可能是放射治疗的候选人.
- 将ICI与辐射等局部疗法结合起来,需要进一步研究以改善HL的结果.
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