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在高级/转移性三阴性乳腺癌中,重建未报告的PD-L1-低表达子组生存数据,使用创新的KMS减法工作流程

Yan Li¹, Xueyan Liang², Huijuan Li²

¹Department of Clinical Pharmacy, Guangxi Academy of Medical Sciences and the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.

Journal for immunotherapy of cancer

|January 11, 2024

概括

免疫检查点抑制剂 (ICI) 不能改善晚期三阴性乳腺癌 (TNBC) 患者的生存结果,这些患者具有较低的编程死亡配体1 (PD-L1) 表达. 这一发现表明,化疗可能是这个患者亚组更合适的治疗选择.

科学领域:

在瘤学瘤学.
免疫治疗是一种免疫疗法.
乳腺癌研究研究乳腺癌研究

背景情况:

免疫检查点抑制剂 (ICI) 已在高级/转移性三阴性乳腺癌 (TNBC) 具有高编程死亡配体1 (PD-L1) 表达的治疗中显示出有效性.
在低PD-L1表达率的TNBC患者中,ICI的益处仍然不确定.
这项研究调查了使用ICI治疗的PD-L1表达低的TNBC患者的生存结果.

研究的目的:

评估基于免疫检查点抑制剂 (ICI) 的疗法在患有晚期/转移性三阴性乳腺癌 (TNBC) 的患者中,表达低水平的编程死亡配体1 (PD-L1) 的疗效.
进行随机对照试验 (RCT) 的生存数据的综合分析,以确定ICI是否在这个特定的患者亚组中提供生存益处.

主要方法:

在Embase,PubMed,MEDLINE和CENTRAL数据库中进行了系统的文献搜索,直到2023年5月18日.
包括RCT报告的无进展生存率 (PFS),总生存率 (OS),或响应的持续时间 (DOR) 的转移性TNBC治疗ICI-based方案.
提取了卡普兰-梅尔曲线,用于低PD-L1亚组使用KMS减法;对生存数据进行了聚合分析.

主要成果:

分析了4项涉及3022名患者的RCT,包括PD-L1免疫细胞 (IC) <1%和综合阳性评分 (CPS) <1或1≤CPS<10.
与低PD-L1亚组中的化疗相比,ICI-化疗组合没有显著改善OS,PFS或DOR (Impassion130,Impassion131,KEYNOTE-355).
在KEYNOTE-119中, pembrolizumab在CPS<1和1≤CPS<10小组中增加了瘤进展的风险. 聚合分析证实,在低PD-L1亚组中,ICI化疗与化疗之间没有显著的OS或PFS益处.

结论:

基于免疫检查点抑制剂 (ICI) 的疗法在患有晚期/转移性三阴性乳腺癌 (TNBC) 的患者中没有显示出对化疗的生存益处,这些患者表现出低编程死亡配体1 (PD-L1) 表达.
这些发现表明,单独的化疗可能是TNBC患者低PD-L1表达的更合适的治疗策略.

关键词:

药物治疗,组合治疗.免疫检查点抑制剂免疫检查点抑制剂免疫治疗是一种免疫疗法.编程细胞死亡1受体

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