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在R-CHOP后完全缓解的高风险扩散性大B细胞淋巴瘤患者中,阿特佐利祖马布的巩固

Marcel Nijland¹, Djamila E Issa², Johanna A A Bult¹

¹University Medical Center Groningen, Groningen, Netherlands.

|April 18, 2025

概括

巩固高风险的扩散性大B细胞淋巴瘤 (DLBCL) 治疗阿特佐利祖马布显著降低了复发风险,并在R-CHOP治疗后实现完全代谢缓解的患者中改善了生存率.

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:

高风险扩散性大B细胞淋巴瘤 (DLBCL) 患者在R-CHOP治疗后面临20-25%的复发风险,即使在完全代谢缓解 (CMR) 中.
确定减轻这种复发风险的策略对于改善DLBCL患者的治疗结果至关重要.

研究的目的:

评估阿特佐利祖马布,PD-L1检查点抑制剂的疗效,作为巩固疗法,以减少高风险DLBCL患者的复发风险.
评估阿特佐利祖马布巩固对该患者群体无病生存期 (DFS) 和整体生存期 (OS) 的影响.

主要方法:

一项II期的开放性试验 (NCT03463057) 招募了109名DLBCL患者,他们的国际预后指数 (IPI) 在CMR后R-CHOP中得分≥3.
患者接受了阿特佐利祖马布 (1200毫克每3周为18个周期) 作为巩固疗法.
主要终点是2年的DFS;次要终点包括OS和安全性 (CTCAE v4.0).

主要成果:

两年的DFS为87.9%,超过了89%的目标,并显著改善了历史数据 (79%).
两年后的生存率为96.3%,与基于人口的对照队列相比,显示出显著的生存益处.
79%的患者出现了不良事件,18%的患者经历了与免疫相关的不良事件 (4.5%为3-4级).

结论:

与历史对照相比,阿特佐利祖马布整合疗法在高风险DLBCL患者中显著改善了DFS.
与基于人口的队列相比,阿特佐利祖马布治疗组的整体存活率显著提高.
这些发现支持进一步研究免疫检查点抑制剂作为DLBCL的整合策略.

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