在转移性黑色素瘤中结合免疫疗法序列的国际现实研究
Mora Guardamagna1, Sarah E Lochrin2, James William Smithy2,3
1Département de médecine oncologique, Gustave Roussy, Villejuif, France.
Journal for immunotherapy of cancer
|November 28, 2025
概括
在与ipilimumab+nivolumab相关之前对ipilimumab+nivolumab进行测序可能会改善晚期黑色素瘤的结果. 响应初始免疫疗法的患者从随后的治疗中获益更多,这突显了最佳ICI测序的重要性.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 黑色素瘤治疗方法
背景情况:
- 像PD-1抑制剂这样的免疫检查点抑制剂 (ICI) 已经改变了黑色素瘤护理.
- 包括relatlimab+nivolumab (rela/nivo) 在内的ICI的最佳序列尚未得到很好的定义.
- 错误的测序可以降低治疗的有效性和长期的患者益处.
研究的目的:
- 评估不同ICI测序策略对晚期黑色素瘤患者结局的影响.
- 为了比较rela/nivo跟着ipilimumab+nivolumab (ipi/nivo) 与ipi/nivo跟着rela/nivo,以及anti-PD-1跟着rela/nivo.
- 确定ICI的最佳顺序,以最大限度地提高患者的反应和存活率.
主要方法:
- 一项涉及190名患者的多中心研究,涉及三个不同的ICI治疗序列.
- 臂 A: rela/nivo 然后 ipi/nivo (N=40).
- 手臂B:ipi/nivo 然后是rela/nivo (N=71).
- 手臂C:抗PD-1然后是相对的 (N=79).
- 评估结果:应答率,无进展生存率和整体生存率 (OS).
主要成果:
- 第二线治疗反应率:C手臂 (30.4%),B手臂 (28.1%),A手臂 (17.5%).
- 二次ICI耐药性对随后的治疗反应更好,特别是在B臂 (p=0.0026).
- 第一次ICI的中位数OS:B臂 (40.9个月),C臂 (42.5个月),A臂 (16.3个月).
结论:
- 在抗PD-1或ipi/nivo治疗后,rela/nivo表现出活性.
- 在rela/nivo之前排序ipi/nivo似乎优于反向序列.
- 结合疗法的先前反应对后续ICI治疗的益处产生积极影响.
- 进一步的研究对于完善ICI测序对于晚期黑色素瘤至关重要.
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