对于患有晚期非小细胞肺癌的患者的免疫疗法,除EGFR外,还存在瘤原体驱动因子的改变:一个多中心的现实世界分析
Tian Tian1, Yanying Li1, Juan Li2
1Division of Thoracic Tumor Multimodality Treatment and Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
免疫检查点抑制剂 (ICI) 在具有KRAS突变的晚期非小细胞肺癌 (NSCLC) 中显示出益处,特别是当PD-L1阳性时. 其他瘤驱动因素的改变可能对ICI的反应有限.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 基因组学就是基因组学.
背景情况:
- 免疫检查点抑制剂 (ICI) 是高级非小细胞肺癌 (NSCLC) 的关键治疗方法.
- 目前正在研究ICI在患有特定瘤驱动因子改变 (不包括EGFR) 的NSCLC的疗效.
- 现实世界的数据对于了解不同NSCLC患者群体的ICI治疗至关重要.
研究的目的:
- 评估免疫检查点抑制剂 (ICI) 在患有瘤驱动因子改变的晚期非小细胞肺癌 (NSCLC) 患者的实际有效性和安全性.
- 为了比较不同基因变异的ICI治疗结果,包括KRAS,HER2,BRAF,MET,ALK和ROS1.
- 为了确定潜在的预测生物标志物,用于ICI响应在基因驱动NSCLC.
主要方法:
- 一项多中心的回顾性研究分析了216名具有基因变异 (KRAS, HER2, BRAF, MET, RET, ALK, ROS1) 的非小细胞癌患者.
- 患者接受ICI单疗或组合治疗,收集了临床病理学特征,疗效和安全性的数据.
- 评估结果是基于一线与二线或后期治疗,特定基因变异和PD-L1表达.
主要成果:
- 第一线免疫治疗方案的中位数无进展生存期 (PFS) 为7.5个月,总生存期 (OS) 为24.8个月.
- KRAS突变NSCLC在一线ICI (中位数PFS 7.8个月,OS 26.1个月) 和在化疗后进展的患者中 (中位数PFS 5.9个月,OS 17.1个月) 显示出有前途的结果.
- 在KRAS组中,PD-L1阳性 (TPS≥1%) 与更好的PFS和OS有关;然而,ICI有效性对于ALK,RET,ROS1,MET或BRAF突变的NSCLC是有限的.
结论:
- KRAS突变NSCLC患者可以从ICI中受益,PD-L1阳性可能预测出积极反应.
- 对于具有ALK,RET,ROS1,MET或BRAF突变的NSCLC,向疗法可能比ICI更有效.
- 需要进一步的研究,以确定可靠的预测生物标志物,以免疫疗法响应在基因驱动的NSCLC.
更多相关视频
09:38Establishment and Characterization of Three Afatinib-resistant Lung Adenocarcinoma PC-9 Cell Lines Developed with Increasing Doses of Afatinib
Published on: June 26, 2019
09:38Establishing Dual Resistance to EGFR-TKI and MET-TKI in Lung Adenocarcinoma Cells In Vitro with a 2-step Dose-escalation Procedure
Published on: August 11, 2017
相关概念视频
Tumor Immunotherapy
Targeted Cancer Therapies
There are several types of targeted therapies against...
Combination Therapies and Personalized Medicine
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
Cancer Vaccines
Cancer vaccines come in two categories: preventive (prophylactic) and treatment (active). Preventive vaccines, such as the Human Papillomavirus (HPV) vaccine, protect against viruses that cause certain...
Cancer Therapies
However, cancer treatments can pose several challenges, as therapies used to kill cancer cells are generally also toxic to normal cells. Moreover, cancer cells mutate rapidly and can develop resistance to chemical agents or radiation therapy. Besides, all types of cancer cells may not respond to the same therapy. Some cancer cells respond to one...
Mitogens and the Cell Cycle
