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在新辅助免疫疗法后,病理反应与长期生存结果的关联:元分析

Chenyu Wei¹, Haolin Sun¹, Jiexuan Hu¹

¹Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.

International immunopharmacology

|April 30, 2024

概括

在新辅助免疫治疗后的病理反应强烈预测了患者水平上改善的生存率. 然而,这种关联在试验水平上没有得到证实,这凸显了需要新的代用终点的需要.

科学领域:

在瘤学瘤学.
免疫治疗是一种免疫疗法.
临床试验临床试验

背景情况:

病理反应,包括完整的病理反应 (pCR) 和主要的病理反应 (MPR),与化疗/化疗放射治疗中的更好的生存率有关.
有限的研究存在于新辅助免疫疗法设置中的病理反应.

研究的目的:

评估病理反应 (pCR/MPR) 与长期生存结果 (EFS/OS) 之间的关联.
为了评估这种关联,在患者和试验层面对新辅助免疫治疗进行评估.

主要方法:

在PubMed,Embase,Cochrane图书馆和会议摘要的系统文献搜索,截至2023年6月1日.
包含报告无事件生存率 (EFS) 或总生存率 (OS) 的研究,按pCR/MPR状态.
患者级分析 (39项研究,4100名患者) 和试验级分析 (5项RCT).

主要成果:

在患者层面上,pCR显著与改善的EFS (HR,0.48) 和OS (HR,0.55) 相关.
MPR显示了与改善EFS (HR,0.31) 和OS (HR,0.43) 的类似关联.
在试验水平上没有发现pCR和EFS之间的显著关联 (P=0.8).

结论:

在固体瘤的新辅助免疫疗法中,病理反应是患者水平上长期存活的强有力的预测因素.
病理反应与存活率之间的关联无法在试验水平上得到验证.
需要进一步的研究来确定可靠的代孕终点,无论是患者还是试验水平.

关键词:

完整的病理反应.没有事件的生存率.主要病理反应的主要病理反应新辅助免疫疗法新辅助免疫疗法总体生存率总体生存率

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