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晚期NSCLC的最佳免疫疗法持续时间:定义理想的治疗窗口

Kaibo Ding^1,2, Dujiang Liu^1,2, Xinyue Li^1,2

¹Department of Medical Thoracic Oncology, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou 310022, China.

Cancer biology & medicine

|February 10, 2025

概括

持续免疫检查点抑制剂 (ICI) 治疗超过18个月,改善了晚期非小细胞肺癌 (NSCLC) 患者的整体存活率,特别是那些病情稳定的人. 对于实现完全或部分反应的患者,建议进行个性化治疗.

科学领域:

在瘤学瘤学.
免疫治疗是一种免疫疗法.
肺癌研究研究肺癌研究

背景情况:

免疫检查点抑制剂 (ICI) 在高级非小细胞肺癌 (NSCLC) 中显示出有效性.
在现实环境中,ICI治疗的最佳持续时间及其对生存的影响仍在调查中.
关于ICI治疗持续时间的数据有限,按最佳整体反应 (BOR) 分层分层.

研究的目的:

评估ICI治疗持续时间和晚期NSCLC患者的整体存活率 (OS) 之间的关联.
为了比较6-18个月用ICI治疗的患者与至少18个月治疗的患者的结局.
根据ICI治疗持续时间分析BOR对生存的影响.

主要方法:

在江癌症医院接受ICI治疗的晚期NSCLC患者的回顾性队列研究 (2017-2022).
数据收集到2024年5月1日;统计分析进行了2024年5月至6月.
在487名查患者中确定了134名符合条件的患者;分析重点是ICI持续时间和BOR.

主要成果:

接受≥18个月ICI治疗的患者与接受6-18个月治疗的患者相比,显示出更高的存活率 (P=0.039).
经过≥18个月治疗的稳定疾病 (SD) 患者的中位寿命明显长于接受6-18个月治疗的患者 (P=0.019).
在接受≥18个月ICI治疗的完全/部分响应 (CR/PR) 患者中观察到更长寿命的趋势,但缺乏统计学意义 (P=0.177).

结论:

现实世界的证据表明,持续ICI治疗超过18个月可能有利于没有进展性疾病的晚期NSCLC患者.
对于达到SD的患者来说,至少18个月的ICI持续时间似乎是合适的;对于CR/PR患者来说,个性化的决定至关重要.
需要进一步的前性研究来验证这些发现,因为在此回顾性分析中存在潜在的偏见.

关键词:

免疫检查点抑制剂免疫检查点抑制剂治疗的持续时间.免疫疗法免疫疗法免疫治疗重新挑战免疫疗法非小细胞肺癌的肺癌.

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