在细胞癌中辅助免疫疗法后的第一线系统疗法:国际多中心研究
Talal El Zarif1, Karl Semaan2, Wanling Xie3
1Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
European urology
|August 15, 2024
概括
在辅助免疫治疗后复发性细胞癌 (RCC) 患者对随后的全身疗法有反应. 有有利风险的患者可能更受益于血管内皮生长因子向治疗 (VEGF-TT),而不是免疫瘤学 (IO) 方案.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 细胞癌研究 细胞癌研究
背景情况:
- 辅助 pembrolizumab 改善了细胞癌 (RCC) 的整体存活率 (OS).
- 对于RCC的辅助免疫瘤学 (IO) 方案后的顺序治疗,现实世界的数据有限.
- 了解辅助IO后的第一线 (1L) 系统治疗的结果至关重要.
研究的目的:
- 为了评估1L系统疗法的临床结果,在辅助IO基疗法后,在患有复发性RCC的患者中.
- 根据治疗类型,复发时间和风险组分析无进展生存率 (PFS) 和总生存率 (OS).
- 在这个患者队列中评估与治疗相关的不良事件.
主要方法:
- 在29个国际机构对94名患有复发性RCC后辅助IO的患者进行了回顾性研究.
- 卡普兰-梅尔法用于估计PFS在1L系统治疗.
- 根据1L治疗类型,复发时间 (<3个月 vs. >3个月) 和国际转移性RCC数据库联盟 (IMDC) 风险组进行的子分析.
主要成果:
- 18个月的PFS和OS率分别为45%和85%.
- 骨转移在辅助IO治疗3个月内复发的患者中更频繁 (20%) 与超过3个月 (2.2%) 相比.
- 常见的1L疗法包括血管内皮生长因子向治疗 (VEGF-TT),IO + VEGF-TT和IO + IO.
结论:
- 一部分患有复发性RCC后辅助IO的患者对随后的全身治疗有反应,包括基于VEGF-TT和IO的疗法.
- 在这种情况下,有利风险患者可能会从VEGF-TT中获得更多的益处,而不是IO疗法.
- 未来的研究应该专注于放射工具和基于生物标志物的液体活检,以检测隐性疾病并指导辅助IO治疗选择.
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