使用现实世界证据的非小细胞肺癌的治疗模式和结果
Rosalyn Marar1, Claire Bai2, Eric Hansen2
1Division of Medical Oncology, Mayo Clinic, Rochester, MN.
Clinical lung cancer
|August 29, 2025
概括
在具有高PD- L1表达的转移性非小细胞肺癌 (mNSCLC) 中,添加免疫检查点抑制剂 (ICI) 的化疗并没有改善存活率,尽管组合治疗的下一次治疗时间较长.
科学领域:
- 癌症学
- 免疫疗法
- 临床试验
背景情况:
- 高PD- L1表达的转移性非小细胞肺癌 (mNSCLC) 的第一线治疗正在发展.
- 免疫检查点抑制剂 (ICI) 已经显示出有效性,但它们与化疗的结合需要在特定患者群体中进行进一步的研究.
研究的目的:
- 为了比较ICI单疗与ICI加化疗 (CIT) 在PD- L1表达率≥50%且没有可向突变的mNSCLC患者的第一线治疗中的实际有效性.
主要方法:
- 使用现实数据库确定了符合纳入标准的311名mNSCLC患者.
- 患者接受了第一线ICI单一治疗或CIT.
- 分析了包括时间到下一次治疗 (rwTTNT),无进展生存率 (rwPFS) 和整体生存率 (rwOS) 在内的结果,使用治疗权重的逆概率 (IPTW) 来进行调整的比较.
主要成果:
- 与ICI单独治疗组 (n=178) (7. 63个月) 相比,CIT组 (n=133) 的调整中位数rwtNT更长 (11. 31个月).
- 然而,调整后的中位数rwPFS (CIT为8. 78个月,ICI为5. 56个月) 或调整后的中位数rwOS (CIT为23. 08个月,ICI为20. 28个月) 没有显著差异.
结论:
- 与ICI单一治疗相比,在该患者队列中,虽然CIT导致治疗时间更长,但它没有转化为改善无进展生存率或整体生存率.
- 在第一线mNSCLC患者中,加上ICI的化疗似乎没有提高生存结果,PD- L1表达高且没有可向的驱动突变.
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