晚期固体瘤患者对双重免疫检查点阻塞的长时间反应:一个病例系列
Camila B Xavier1, Mohamed A Gouda1, Apostolia M Tsimberidou2
1Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
NPJ precision oncology
|October 9, 2025
概括
使用抗CTLA4/抗PD1治疗的免疫疗法在晚期癌症中显示出有希望的长期结果. 对免疫相关不良事件 (irAEs) 的仔细管理对于免疫治疗的成功结果至关重要.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 医疗成像医学成像
背景情况:
- 免疫疗法已经彻底改变了癌症治疗.
- 五名患有晚期癌症 (直肠,结肠,前列腺,神经内分泌) 的患者未能接受标准治疗.
- 这些患者参加了涉及抗CTLA4和抗PD1治疗的临床试验.
研究的目的:
- 目前的病例中,晚期癌症患者通过免疫疗法实现了长期无进展生存 (PFS).
- 突出免疫相关不良事件 (irAEs) 的成功管理.
- 为了证明个性化患者监测在免疫治疗中的价值.
主要方法:
- 针对五名晚期癌症患者的病例系列,这些患者接受了抗CTLA4/抗PD1治疗.
- 监测无进展生存 (PFS) 和与免疫相关的不良事件 (irAEs).
- 使用正子发射断层扫描 (PET) /计算机断层扫描 (CT) 扫描对治疗反应的评估.
主要成果:
- 观察到延长的PFS:Pt1 (MSS直肠腺癌,34个月以上),Pt2 (神经内分泌癌,68个月),Pt3 (MSS结肠腺癌,38个月以上),Pt4 (dMMR前列腺腺癌,68个月以上),Pt5 (神经内分泌癌,69个月以上).
- 四名患者经历了3级irrAEs,成功管理,允许继续抗PD1治疗.
- PET/CT扫描显示,4名患者中有3名患者的完整反应,最初在CT扫描上显示部分反应.
结论:
- 精选的晚期癌症患者可以通过免疫疗法 (抗CTLA4/抗PD1) 实现特殊的结果.
- 个性化管理irrAEs对于持续的免疫疗法治疗至关重要.
- 需要进一步的研究来确定预测免疫疗法反应和毒性的生物标志物.
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