肺部间皮瘤患者的新辅助全身疗法:系统性审查
Illaa Smesseim1,2, Jo Raskin3,4,5, Jacobus A Burgers1
1Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
Translational lung cancer research
|November 14, 2025
概括
新辅助化学疗法是常见的肺间皮瘤,但它的好处与手术是不清楚的. 需要更多的试验来找到最佳策略,并确定从新辅助疗法中受益最多的患者.
科学领域:
- 在瘤学瘤学.
- 胸部外科手术 胸部外科手术
- 临床试验 临床试验
背景情况:
- 排骨间皮瘤是一种具有挑战性的治疗决策的侵袭性癌症.
- 胸膜间皮瘤手术的有效性受到争议,特别是关于切除性疾病的定义.
- 正在探索新辅助疗法,以减少手术前的瘤负担.
研究的目的:
- 系统地审查前性新辅助药试验在多间皮瘤.
- 确定可能受益于新辅助疗法的患者子组.
- 评估手术前的全身疗法在治疗多间皮质瘤中的作用.
主要方法:
- 系统搜索从开始到2024年7月的II/III期前性试验.
- 纳入标准:成年患者具有组织学确认的肺间皮瘤,接受新辅助全身疗法,然后进行手术.
- 数据提取包括患者人口统计,治疗细节,手术结果,生存数据和不良事件.
主要成果:
- 分析了16项涉及1,184名患者的试验;大多数患者是男性 (72.7%),平均年龄为57-69岁.
- 新辅助化疗是主要的方法 (15项试验),其中一项试验探索免疫疗法.
- 在61.8%的患者中,进行了手术,主要是通过外多肺切除术 (EPP). 总生存时间的中位数有所不同,在一个结合新辅助化疗和手术的III期试验中,与单独化疗相比,总生存时间更短的显著发现 (19.3 vs 24.8 个月).
结论:
- 双重化疗是主要的新辅助策略,而免疫疗法的作用正在研究中.
- 目前的证据表明,需要进行进一步的随机试验,以优化新辅助治疗.
- 识别特定的患者亚组,这些患者从新辅助方法中获益最多,对于改善膜间皮瘤的结果至关重要.
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