在先进的,可切割的皮肤状细胞癌中,新辅助药意图免疫疗法
Emily Y Kim1, Emily S Ruiz1,2,3, Mia S DeSimone1,3
1Brigham and Women's Hospital, Boston, Massachusetts.
JAMA otolaryngology-- head & neck surgery
|March 28, 2024
概括
新辅助性免疫检查点抑制剂 (ICI) 在晚期皮肤状细胞癌 (cSCC) 中表现出临床活性,包括在淋巴瘤等并发症患者中. 响应率显著,一些患者因瘤回归而选择退出手术.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 皮肤病学 皮肤病学
背景情况:
- 术前免疫检查点抑制剂 (ICI) 在晚期皮肤状细胞癌 (cSCC) 中表现出临床活性.
- 以前的临床试验往往排除了具有重大并发症的患者,限制了现实世界的适用性.
研究的目的:
- 在多样化的临床群体中评估新辅助剂意图编程细胞死亡蛋白1 (PD-1) ICI的放射和病理反应率.
- 评估生存结果,包括无复发,无进展,疾病特异性和整体生存.
主要方法:
- 一项涉及27名晚期cSCC患者的队列研究,这些患者在2018年1月至2023年1月期间接受了新辅助药CEMIPLIMAB或PEMBROLIZUMAB治疗.
- 随访时间中位数为9.5个月,评估了放射性和病理反应率,以及生存终点.
主要成果:
- 观察到的整体病理反应率为47.4%,放射反应率为50.0%.
- 病理完整反应 (pCR) 率为36.8%. 一年生存率很高:没有复发 (90.9%),没有进展 (83.3%),特定于疾病 (91.7%) 和整体 (84.6%).
- 值得注意的是,18.5%的患者因瘤反应或稳定性而拒绝手术.
结论:
- 针对cSCC的新辅助剂意图免疫治疗在临床环境中是可重现的,即使在患有伴随疾病的患者中,如淋巴瘤病史.
- 该研究强调,在现实实践中,患者可能会放弃对回归瘤的手术,并将高风险患者纳入可能会影响应答率.
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