临床和转化研究ivosidenib加nivolumab在先进的固体瘤的IDH1突变
Matthew K Nguyen1,2,3, Mark Jelinek1,4, Arjun Singh1,5
1Hillman Cancer Center, UPMC, Pittsburgh, PA, USA.
medRxiv : the preprint server for health sciences
|August 8, 2025
概括
这项研究发现,在IDH1突变的晚期固体瘤中,结合ivosidenib和nivolumab显示出有限的抗瘤活性,主要是疾病稳定. 需要通过免疫检查点抑制剂对IDH1抑制进行进一步的研究.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 癌症新陈代谢 癌症新陈代谢
背景情况:
- 免疫疗法耐药性与非T细胞炎症瘤微环境 (TME) 有关.
- IDH1突变在非T细胞炎症瘤中被丰富,可以促进免疫排除.
- 在临床前模型中,IDH抑制已经显示出增强抗瘤免疫力的潜力.
研究的目的:
- 评估ivosidenib (IDH1抑制剂) 与nivolumab (抗PD1) 结合在IDH1-突变高级固体瘤患者中的初步活性.
- 评估这种联合治疗的安全性和有效性.
- 进行翻译分析以了解底层机制.
主要方法:
- 在患有具有IDH1突变的晚期或耐火固体瘤的患者中,ivosidenib加nivolumab的II期临床研究.
- 每天口服伊沃西迪尼布 (500毫克) 和每4周一次静脉注射尼沃卢马布 (480毫克).
- 复合主终点:六个月无进展生存率 (PFS6) 或整体反应率 (ORR);翻译研究包括药理动力学,蛋白质学和空间转录学分析.
主要成果:
- 招募了15名患者;3人 (20%) 达到主要终点 (1人与PFS6部分响应,2人单独使用PFS6).
- 平均PFS为1.94个月;常见的不良事件包括白血病和皮疹.
- 药理动力学研究显示血 (R) - 2HG下降,并建议免疫调节效应.
结论:
- 艾沃西迪尼布和尼沃卢马布的组合在治疗不耐药的mIDH1固体瘤中是安全的.
- 抗瘤活性与ivosidenib单一治疗类似,主要是疾病稳定.
- 翻译数据支持进一步调查IDH1抑制与免疫检查点抑制相结合的情况.
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