新辅助剂和辅助剂布罗利祖马布用于局部发达的头癌
Ravindra Uppaluri1,2, Robert I Haddad1,2, Yungan Tao3
1Brigham and Women's Hospital, Harvard Medical School, Boston.
The New England journal of medicine
|June 18, 2025
概括
在标准护理中添加外科手术期间的 pembrolizumab 显著改善了局部晚期头支状细胞癌 (HNSCC) 患者的无事件生存率. 这种免疫疗法方法没有影响手术完成率,也没有引发新的安全问题.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 头部和部癌症 头部和部癌症
背景情况:
- 术前 pembrolizumab 与局部晚期头支状细胞癌 (HNSCC) 的标准护理相结合的疗效仍然不确定.
- 标准护理通常包括手术,辅助放射治疗和潜在的化疗.
研究的目的:
- 评估添加新辅助剂和辅助剂 pembrolizumab 加入标准护理对局部发达HNSCC患者无事件生存的影响.
- 评估 pembrolizumab 对手术完成率和安全概况的影响.
主要方法:
- 一项第三阶段的开放性试验,随机分配了局部发达HNSCC的患者,接受标准护理加上 pembrolizumab 或仅接受标准护理.
- 布罗利祖马布作为2个循环的新辅助治疗和15个循环的辅助治疗.
- 主要终点是无事件存活率,分析了不同编程死亡-1 (PD-L1) 组合阳性得分 (CPS) 群体 (CPS≥10,CPS≥1和所有参与者).
主要成果:
- 在所有分析的人群中,36个月的无事件存活率在pembrolizumab组显着更高 (CPS≥10:59.8%与45.9%相比;CPS≥1:58.2%与44.9%相比;总数:57.6%与46.4%).
- 在所有人群中,进展,复发或死亡的危险比率有利于布罗利祖马布组.
- 3级或更高的与治疗相关的不良事件在两组之间是可比的 (44.6%与42.9%对比),布罗利祖马布组的死亡发生率略高 (1.1%与0.3%对比).
- 3级或更高的潜在免疫媒介不良事件发生在pembrolizumab组的10.0%中.
结论:
- 将新辅助剂和辅助剂 pembrolizumab 添加到标准治疗中,可显著提高局部发达 HNSCC 的患者无事件生存率.
- 布罗利祖马布的使用并没有对手术完成率产生负面影响.
- 该研究在该患者队列中没有发现与外科手术前 pembrolizumab 相关的新的安全问题.
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