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同时免疫治疗改善了无进展的生存率,但在不可切除的III期NSCLC中增加了毒性

Yiwei Qin¹, You Mo², Pengwei Li³

¹Department of Radiation Oncology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, People's Republic of China; Department of Shandong Provincial Key Laboratory of Precision Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong 250000, People's Republic of China.

Lung cancer (Amsterdam, Netherlands)

|April 20, 2025

概括

巩固免疫疗法 (IO) 与化学放射疗法并发改善了不可切除的第三阶段非小细胞肺癌 (NSCLC) 的无进展生存期 (PFS). 然而,由于严重不良事件的增加,整体存活率 (OS) 没有受益,这表明要小心选择患者同时接受IO.

科学领域:

在瘤学瘤学.
胸部癌症胸部癌症乳腺癌
免疫治疗是一种免疫疗法.

背景情况:

帕西菲克试验确定了第三阶段不可切割的非小细胞肺癌 (NSCLC) 的化学放射治疗后的巩固免疫疗法 (IO).
在NSCLC治疗中IO的最佳时间仍然是一个关键的临床问题.
这项研究比较了与放射治疗 (RT) 同步IO与RT后的顺序IO.

研究的目的:

在不可切割的III期NSCLC中分析并发与顺序免疫治疗的生存结果和风险.
评估IO时间对无进展生存 (PFS) 和整体生存 (OS) 的影响.
评估与不同IO计时策略相关的安全概况,包括严重不良事件 (AE).

主要方法:

系统性文献综述和对比同步IO-RT与NSCLC的顺序IO的研究的元分析.
使用R元包,分析整体存活 (OS),无进展存活 (PFS) 和不良事件 (AE).
通过单中心队列研究进行验证,以确认PFS和治疗间隔的发现.

主要成果:

分析显示,同步IO-RT的1年和1.5年后,PFS显著改善.
顺序IO显示略有改善的生存状况,但严重不良事件的发生率较低 (等级≥3).
一个单中心队列证实了与IO-RT并发的优异PFS (HR=2.039,P=0.046);较短的RT-IO间隔与更好的PFS相关.

结论:

与RT同时使用IO显著增强了不可切除的III期NSCLC中的PFS.
虽然由于严重的副作用增加,没有观察到OS益处,但早期IO启动后的RT改善了PFS.
同时IO可能为精心挑选的NSCLC患者提供好处,需要进一步调查.

关键词:

化学疗法或放射疗法免疫检查点抑制剂免疫检查点抑制剂免疫治疗是一种免疫疗法.非小细胞肺癌是非小细胞肺癌.没有进展的生存率.辐射疗法辐射疗法

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