什么时候停止免疫治疗晚期黑色素瘤:模拟目标试验
Mathilde Amiot1, Laurent Mortier2, Stéphane Dalle3
1AP-HP Dermato-oncology, Cancer Institute APHP Nord Paris Cité, Saint Louis Hospital, Paris, France.
EClinicalMedicine
|December 24, 2024
概括
对于晚期黑色素瘤,免疫检查点抑制剂 (ICI) 的最佳持续时间是一年. 在抗PD-1治疗一年后停止治疗显示出更好的生存率,而长期使用超过两年可能是有害的.
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:
- 免疫检查点抑制剂 (ICI) 为晚期黑色素瘤提供了显著的生存益处.
- 目前的治疗方案包括持续治疗或最长两年.
- 抗PD-1治疗的最佳持续时间仍未确定,需要进一步调查.
研究的目的:
- 评估免疫检查点抑制剂 (ICI) 给晚期黑色素瘤患者的最佳持续时间.
- 为了比较在特定时间点中停止与继续ICI的结果.
主要方法:
- 使用克隆,加权和审查方法对MelBase队列 (2015-2021) 的目标试验的模拟.
- 对控制疾病的患者中断治疗与在6个月,12个月,18个月和24个月继续治疗的比较.
- 总生存时间 (OS) 和受限平均生存时间 (RMST) 的分析.
主要成果:
- 在6个月后停止ICI,与继续治疗相比,OS显著降低 (48个月后37.8%的生存差异).
- 在12个月或18个月停止或继续ICI时没有观察到明显的益处.
- 在24个月终止ICI显示了有利于停止治疗的趋势,48个月生存率更高 (10.5%绝对差异).
结论:
- 对于晚期黑色素瘤患者来说,一年的免疫疗法似乎是必要和足够的.
- 超过两年的长期ICI治疗可能不会改善存活率,可能会有害.
- 研究结果表明,在晚期黑色素瘤的治疗一年后停止抗PD-1治疗可能有好处.
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