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丸癌患者的免疫检查点抑制剂:系统性审查

Carlos Eduardo Salazar-Mejía¹, Rosalaura Virginia Villarreal-González¹, Oscar Vidal-Gutiérrez¹

¹Oncology Service, Centro Universitario Contra el Cáncer (CUCC), Hospital Universitario "Dr. José Eleuterio González," Faculty of Medicine, Universidad Autónoma de Nuevo León, Monterrey, Mexico.

Journal of adolescent and young adult oncology

|December 24, 2024

概括

免疫检查点抑制剂 (ICI) 在抗化疗生殖细胞瘤 (GCTs) 中表现出有限的疗效. 在高瘤突变负担 (TMB-H) 或MSI-H/dMMR GCT患者中观察到持久的反应.

科学领域:

在瘤学瘤学.
免疫治疗是一种免疫疗法.

背景情况:

胚胎细胞瘤 (GCTs) 通常是化学敏感的,但一个子集变得耐化学疗,这给治疗带来了重大挑战.
免疫检查点抑制剂 (ICI) 已被批准用于化学疗法耐药的GCT,但支持证据有限.

研究的目的:

系统地审查免疫检查点抑制剂 (ICI) 在耐化疗生殖细胞瘤 (GCTs) 患者的疗效.

主要方法:

一项系统的文献搜索确定了13项研究 (n=106),包括病例报告,回顾性队列和II期随机对照试验 (RCT) 到2023年12月.
研究评估了ICI治疗化学疗法耐药的GCT患者的瘤结局,大多数缺乏生物标志物选择标准.

主要成果:

总体应答率较低 (中位数为3.4%),进展性疾病是最常见的结果 (75%).
在未被选择的患者中,观察到ICI作为单一药物的有限活性.
在高瘤突变负担 (TMB-H) 或高微卫星不稳定性 (MSI-H) /dMMR GCTs患者中观察到持久反应.

结论:

免疫检查点抑制剂在未经选择的化学疗法耐药的GCT患者中显示出有限的有效性.
生物标志物选择,特别是TMB-H或MSI-H/dMMR状态,可以确定可以从ICI治疗中受益的GCT患者.

关键词:

胚胎细胞瘤胚胎细胞瘤免疫检查点抑制剂免疫检查点抑制剂丸癌症丸癌症是什么

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