对免疫治疗的病理反应与因转移性细胞癌而经历延迟切除术的患者的生存率有关
Yash S Khandwala1, Stephen W Reese1,2, Burcin A Ucpinar3
1Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
概括
免疫治疗后的主要病理反应预测转移性细胞癌患者经过整合性切除术后的更长的生存期. 病理反应是指导晚期癌治疗决策的关键.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 免疫治疗是一种免疫疗法.
背景情况:
- 结合性切除术 (CN) 在转移性细胞癌 (mRCC) 患者治疗免疫检查点抑制剂 (ICI) 的作用尚不清楚.
- 了解治疗反应对于优化接受免疫疗法 (IO) 患者的手术选择至关重要.
研究的目的:
- 评估免疫治疗后的放射和病理性瘤反应是否与接受CN的mRCC患者的存活率相关.
- 评估免疫疗法后瘤反应与CN治疗患者的结局之间的关联.
主要方法:
- 用IO和CN (2015-2024) 治疗的mRCC患者的回顾性研究.
- 通过RECIST评估的放射性反应;由残留可活性瘤 (RVT) 评估的病理反应,主要病理反应 (MPR) 定义为RVT<10%.
- 使用Cox比例危险模型分析的无进展生存率 (PFS) 和整体生存率 (OS).
主要成果:
- 15名患者 (26%) 实现了MPR,21名患者 (35%) 产生了放射性反应.
- 放射性反应与RVT有适度的相关性,但与PFS或OS无显著关联.
- MPR与改善的PFS (HR:0.05) 和OS (HR:0.07) 显著相关.
结论:
- 在切除术时患有MPR的患者经历了显著更长的PFS和OS.
- 免疫治疗后的病理反应可能会指导腎切除术后的治疗策略.
- 需要进一步验证IO后的病理终点,以完善临床决策.
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