在资源有限的环境中对免疫检查点抑制剂的挑战和现实世界利用的多中心研究:来自印度的见解和影响
Ashwin Oommen Philips1, Sunu Cyriac2, P Unnikrishnan2
1Department of Medical Oncology, Christian Medical College & Hospital, Ludhiana, Punjab, India.
South Asian journal of cancer
|March 24, 2025
概括
免疫检查点抑制剂 (ICI) 提供先进的癌症治疗,但由于成本,在印度面临进入障碍. 这项研究强调了影响ICI使用和结果的财务限制,并建议降低剂量作为潜在的解决方案.
科学领域:
- 在瘤学瘤学.
- 临床药理学 临床药理学
- 卫生经济学 卫生经济学
背景情况:
- 免疫检查点抑制剂 (ICI) 已经改变了癌症治疗.
- 信息化产品的获取和可负担性是主要的挑战,特别是在资源有限的地区.
- 了解印度的ICI利用对于改善癌症治疗至关重要.
研究的目的:
- 评估印度ICI的利用,成果和挑战.
- 确定影响ICI治疗决策和患者反应的因素.
- 探索在资源有限的环境中增强ICI可访问性的策略.
主要方法:
- 在2018年1月至2021年12月期间在印度多个中心接受ICI治疗的91名患者的回顾性分析.
- 收集的数据包括人口统计,适应症,生物标志物测试,财务保障,毒性和生存结果 (PFS,OS).
- 分析的重点是确定ICI使用的障碍,特别是财务限制.
主要成果:
- 肺癌 (39.6%) 和癌 (11%) 是主要的征兆.
- 生物标志物测试 (PD-L1,TMB) 是有限的.
- 财务限制影响了41.8%的患者,导致17.6%的患者停止治疗.
- 中位数PFS为4.6个月,中位数OS为15.4个月.
- 肺癌队列的PFS中位数为5.7个月,1年的生存率为57.6%.
结论:
- 财务限制严重阻碍了ICI在印度的利用和治疗延续.
- 尽管面临挑战,但结果似乎与以前的研究相比或有所改善,可能是由于更好的患者选择.
- 降低ICI成本,可能通过更低的剂量或生物类似药,对于改善资源有限的环境中的获取和结果至关重要.
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