转移性尿路细胞癌的不断变化的治疗环境
Giandomenico Roviello1, Matteo Santoni2, Guru P Sonpavde3,4,5
1Department of Health Sciences, University of Florence, Florence, Italy. giandomenico.roviello@unifi.it.
Nature reviews. Urology
|May 3, 2024
概括
新的治疗方法,如抗体 - 药物合物和组合疗法,对转移性尿路细胞癌 (mUC) 显示出有前途,改善了不符合或进展 cisplatin 化疗的患者的生存率.
科学领域:
- 在瘤学瘤学.
- 尿癌研究 尿癌研究
- 临床试验 临床试验
背景情况:
- 基于西斯普拉丁的化疗是转移性尿道癌 (mUC) 的标准一线治疗方法,但许多患者不符合条件.
- 现有的治疗方法,包括免疫检查点抑制剂和维护阿维卢马布,提供了好处,但在优化治疗方面仍然存在挑战.
- 抗体药物合物和纤维细胞生长因子受体 (FGFR) 抑制剂在特定患者群体中显示出有前途.
研究的目的:
- 总结一下目前转移性尿道癌 (mUC) 的治疗情况.
- 介绍最近在以前未经治疗的mUC.上进行的第三阶段试验的突破性结果.
- 讨论新兴疗法及其对临床决策的潜在影响.
主要方法:
- 对临床试验证据的审查,包括EV-302/KEYNOTE-A39和CheckMate 901.
- 对新药数据的分析,如恩福图马布维多丁,潘布罗利祖马布,尼沃卢马布和厄尔达菲提尼布.
- 包括关于维护avelumab和FGFR抑制剂mUC的数据.
主要成果:
- 在未经治疗的mUC中,Enfortumab vedotin加上 pembrolizumab显著改善了整体存活率 (OS),无进展存活率 (PFS) 和整体反应率 (ORR) 与化疗相比.
- 在未治疗的mUC中,与单独化疗相比,Nivolumab加上gemcitabine-cisplatin化疗显著延长了中位数的OS,PFS和ORR.
- 在免疫检查点抑制剂治疗后,埃尔达菲提尼布在患有mUC和FGFR变异的患者中表现出比化疗更长的生存期.
结论:
- 新的组合和向疗法正在改变转移性泌尿腺癌的治疗.
- 在一线和后一线设置中的显著进展为mUC患者提供了更好的结果.
- 持续的研究和临床试验对于完善治疗策略和改善患者预后至关重要.
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