对结节阳性肌肉侵入性膀癌的维护治疗:两例病例报告
Darren M C Poon1, Lap Yin Ho2, Yiu Ming Kwong3
1Comprehensive Oncology Centre, Hong Kong Sanatorium & Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.
Frontiers in oncology
|June 12, 2024
概括
节点阳性肌肉侵入性膀癌 (MIBC) 的管理可以通过全身疗法和阿维卢马布维护改善. 这种节约膀的方法显示出有希望的结果,提供延长缓解和维持生活质量.
科学领域:
- 在瘤学瘤学.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 免疫治疗是一种免疫疗法.
背景情况:
- 节点阳性肌肉侵入性膀癌 (MIBC) 是一个严重的临床挑战,预后不佳.
- 目前对结节阳性MIBC的治疗选择有限,激进囊切除术通常是标准的,但正在寻找替代方案.
- 疾病的异质性和缺乏基于证据的选择使治疗决策复杂化.
研究的目的:
- 描述结节阳性MIBC的膀节约管理方法.
- 评估系统治疗的疗效和耐受性,然后在两种情况下维持阿维卢马布.
- 为了突出选择患者的激进囊切除的潜在替代方案.
主要方法:
- 两名结节阳性MIBC患者接受了前期的吉姆西塔/西斯普拉丁化疗.
- 两个患者同时接受化学放射治疗 (cCRT).
- 在cCRT后,使用avelumab (免疫检查点抑制剂) 进行了维持治疗.
主要成果:
- 两名患者在维护阿维卢马布后实现了完全缓解,没有复发或远程转移.
- 患者1在化疗后持续缓解超过两年;患者2在化疗后持续超过一年.
- 阿维卢马布耐受性很好,没有免疫相关的不良事件,生活质量保持良好.
结论:
- 与局部巩固相结合的avelumab维持疗法显示出作为节点阳性MIBC的膀保护策略的潜力.
- 这些发现支持对适合患者的这种方法进行进一步调查.
- 目前正在进行的试验,如INSPIRE,旨在进一步完善这种患者队列的治疗策略.
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