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治疗局部发达甲状腺上皮瘤的外科手术前期 pembrolizumab:一个单臂,第二阶段试验

Yeong Hak Bang¹, Jae Myoung Noh², Boram Lee³

¹Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Digital Health, Samsung Advanced Institute of Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea.

Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer

|October 19, 2025

概括

外科手术期间使用的 pembrolizumab 对发达的胸膜上皮瘤 (TETs) 是有前途的. 这种治疗改善了III-IV期TET患者的重大病理反应和无病生存期 (DFS),特别是胸腺癌.

科学领域:

在瘤学瘤学.
免疫治疗是一种免疫疗法.
胸部外科手术胸部外科手术

背景情况:

完全切除术是对胸膜上皮瘤 (TETs) 的唯一潜在的治愈治疗方法.
研究术前 pembrolizumab,以增强对TETs的反应,切除能力和无病生存 (DFS).

研究的目的:

评估 pembrolizumab 新辅助化疗的疗效和安全性,然后在潜在可切除的TET患者中进行手术和维护 pembrolizumab.
确定主要病理反应 (MPR) 的率作为主要终点.

主要方法:

一个单臂的前性第二阶段试验,涉及患有Masaoka-Koga III-IV阶段TET的患者.
新辅助治疗包括多塞塔克塞尔,西斯普拉丁和潘布罗利祖马布3个周期,随后是手术和两年维护班布罗利祖马布.
在R1/R2切除方面,辅助放射治疗与pembrolizumab一起进行.

主要成果:

招募了40名患者;28人接受了切除. 在46.4%的切除患者中实现了MPR,在17.9%的切除患者中实现了完整的病理反应,仅限于胸腺癌病例.
一年DFS率为91.0%,DFS中位数为49.3个月.
副作用大多是1级或2级;两个胸腺瘤患者发生了致命的心肌炎.

结论:

在外科手术期间, pembrolizumab 在III-IV阶段的TET中显示出令人鼓舞的MPR,R0切除和长期DFS率.
组合疗法显示出潜在的益处,特别是对于胸腺癌.
进一步的研究是有必要的,考虑到在胸腺瘤患者中观察到的毒性.

关键词:

免疫治疗是一种免疫疗法.在本地先进的先进.在外科手术期间的治疗.胸膜上皮瘤胸膜上皮瘤

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