在老年人中使用PD-1/PD-L1抑制剂单疗法与联合疗法:现实世界研究和生存预后的诺姆图
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Updated: Sep 14, 2025

07:04
Identifying PD-1/PD-L1 Inhibitors with Surface Plasmon Resonance Technology
Published on: May 2, 2025
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Yunye Mao1,2, An Wang1,2, Xiangwei Ge1,2
1Senior Department of Oncology, the, Fifth Medical Center , PLA General Hospital, Beijing, 100853, China.
BMC pulmonary medicine
|July 23, 2025
概括
对于患有晚期非小细胞肺癌 (NSCLC) 的老年患者,组合免疫疗法与单疗法相比显著改善了整体存活率. 这种方法是有效和安全的,为这个人群提供了可行的治疗选择.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 非小细胞肺癌 (NSCLC) 是一种非小细胞肺癌.
背景情况:
- PD-1/PD-L1抑制剂已经彻底改变了先进的NSCLC治疗.
- 由于免疫衰老,对于患有NSCLC的老年患者 (≥65岁) 的最佳免疫疗法策略尚不清楚.
- 在这个易受伤害的群体中,缺乏比较单疗法与组合免疫治疗的现实数据.
研究的目的:
- 为了比较PD-1/PD-L1抑制剂单疗与老年晚期NSCLC患者的组合化疗的疗效和安全性.
- 开发一种预后性诺基图,以指导接受免疫治疗的老年NSCLC患者的个性化治疗决策.
主要方法:
- 641名老年患者 (≥65岁) 的多中心回顾性研究,患者患有IIIB/IV期非小细胞癌.
- 对单疗法 (n=149) 与组合疗法 (n=492) 的总生存 (OS),无进展生存 (PFS) 和不良事件 (AE) 的分析.
- 使用LASSO-Cox回归结合临床变量构建预后诺图.
主要成果:
- 与单疗法相比,组合疗法显示出优异的中位数生存期 (35.37 与 20.53 个月相比;P<0.001),但没有PFS (11.87 与 10.67 个月相比;P=0.535).
- 组合疗法的OS益处在75岁以下的患者中是显著的,但在75岁以上的患者中并非如此.
- 组合疗法与任何级别和3-4级别AE的更高率有关.
- 一个综合治疗类型和其他临床因素的预后诺莫грам显示了对1-2年生存期的预测准确性 (AUC 0.70-0.71).
结论:
- 免疫组合疗法为老年高级NSCLC患者提供了比单一疗法更好的OS,是可行的治疗选择.
- 对于75岁及以上的患者,需要进一步评估.
- 一种已开发的预后诺基图准确地预测了接受免疫治疗的老年NSCLC患者的OS.
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