伪进展后持续使用免疫检查点抑制剂改善了肺癌患者的生存率:系统性审查和元分析
Aiben Huang1, Mei Xie2, Chongchong Wu3
1Department of Respiratory and Critical Care, Emergency and Critical Care Medical Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
Journal of thoracic disease
|November 13, 2025
概括
在肺癌的伪进展 (PsP) 后,持续使用免疫检查点抑制剂 (ICI) 显著改善了生存率. 像iRECIST和CT成像工具这样的新标准有助于准确的PsP诊断和管理.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 放射学 放射学是一门学科.
背景情况:
- 伪进展 (PsP) 复杂化了免疫检查点抑制剂 (ICI) 的肺癌患者的治疗决策.
- 准确识别PsP对于优化患者的治疗结果至关重要.
- 像RECIST 1.1这样的现有标准可能错误地将PsP归类为渐进性疾病.
研究的目的:
- 评估PsP后继续或停止ICI治疗的预后影响.
- 开发工具,以改善肺癌中PsP的识别和管理.
主要方法:
- 一个个体患者数据 (IPD) 综合分析了40个PsP病例.
- 使用生存分析对持续ICI和中断ICI组之间的预后进行比较.
- 开发一个胸部CT图案图和一个诊断-治疗框架.
主要成果:
- 持续ICI治疗与显著更长的平均整体存活时间 (16.6 vs 7.4个月) 和更高的12个月存活率 (66.7% vs 40.0%) 相关.
- 在固体瘤中免疫相关反应评估标准 (iRECIST) 与RECIST 1.1相比,改善了PsP分类.
- 为帮助临床识别和管理,制定了胸部CT图案图和提出的诊断治疗框架.
结论:
- 在PsP后继续进行ICI显示了肺癌患者的显著生存益处.
- iRECIST和开发的成像/管理工具提高了PsP诊断和治疗优化.
- 需要进行前性试验来验证拟议的诊断-治疗框架.
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