对免疫疗法的病理反应与因转移性细胞癌而经过延迟切除术的患者的存活率有关
Yash S Khandwala1, Stephen W Reese2, Burcin A Ucpinar3
1Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
European urology oncology
|November 27, 2025
概括
在转移性细胞癌患者免疫检查点抑制剂后的整合性瘤切除术显著改善了存活率,如果达到主要的病理反应. 病理反应是mRCC患者长期结果的关键指标.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 免疫治疗是一种免疫疗法.
背景情况:
- 在用免疫检查点抑制剂 (ICI) 治疗的转移性细胞癌 (mRCC) 患者中,巩固性切除术 (CN) 的作用尚不清楚.
- 了解治疗反应对于选择受益于免疫疗法 (IO) 后手术的患者至关重要.
研究的目的:
- 评估IO后的放射和病理瘤反应是否与接受CN的mRCC患者的生存有关.
- 为接受ICI的mRCC患者进行外科选择提供信息.
主要方法:
- 对接受IO,其次是CN (2015-2024) 治疗的mRCC患者的回顾性研究.
- 根据RECIST标准评估的放射性反应;通过剩余可活性瘤 (RVT <10%的主要病理反应 - MPR) 来评估病理反应.
- 使用Cox比例危险模型分析的无进展生存率 (PFS) 和整体生存率 (OS).
主要成果:
- 15名患者 (26%) 实现了MPR;21名 (35%) 产生了放射性反应.
- 放射性反应与PFS或OS没有显著关联.
- MPR与改善的PFS (HR:0.05) 和OS (HR:0.07) 显著相关.
结论:
- 在IO后在切除术中实现MPR的患者经历了更长的PFS和OS.
- 病理反应是一个有价值的终点,用于指导mRCC的腎切除术后治疗策略.
- 需要进一步验证IO后的病理终点.
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