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立体性身体辐射疗法增强检查点抑制剂免疫疗法响应在重度预处理的转移性骨肉瘤中

Chuanying Zhu¹, Yichen Xu², Junxiang Wen³

¹Department of Oncology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.

International journal of radiation oncology, biology, physics

|December 1, 2025

概括

与免疫检查点抑制剂 (ICI) 结合的立体体辐射疗法 (SBRT) 显著改善了复发性/耐药性骨髓瘤的全身瘤反应和存活率. 这种组合显示出潜在的abscopal效应,值得进一步调查.

科学领域:

在瘤学瘤学.
免疫治疗是一种免疫疗法.
辐射瘤学辐射瘤学

背景情况:

复发性/耐火性 (R/R) 骨髓瘤由于其免疫抑制性瘤微环境,预后不佳.
立体性身体辐射疗法 (SBRT) 具有超出局部瘤控制的免疫调节特性.
在骨髓瘤中,SBRT与免疫检查点抑制剂 (ICI) 的组合尚未先前被探索.

研究的目的:

在R/R骨髓瘤患者中,评估SBRT与ICI结合的疗效和安全性.
调查SBRT与ICI结合的潜在腹腔效应.
确定可预测治疗反应的生物标志物.

主要方法:

对62名R/R骨髓瘤患者的回顾性审查,这些患者接受了ICI加SBRT (n=18),常规辐射疗法 (CRT) (n=23) 或仅ICI (n=21) 的治疗.
对辐射和非辐射病变的放射性反应的评估,以确定全身疗效和腹腔效应.
作为相关生物标志物的外周血液细胞计和内淋巴细胞透的分析.

主要成果:

与仅ICI和ICI+CRT组相比,ICI+SBRT显示显著优异的全身瘤反应和中位数整体存活期 (12.0个月).
观察到一个显著的腹膜效应,在ICI+SBRT组中,非辐射病变的反应更好.
较高的基线CD3+淋巴细胞和较低的中性粒细胞对淋巴细胞比率与更好的腹腔效应相关;在SBRT后观察到内CD8+T细胞透和PD-L1表达的增加.

结论:

与ICI结合的SBRT是一种有前途的策略,可以提高R/R骨髓瘤的免疫疗法疗效.
这种组合可以克服免疫抑制瘤微环境,并诱导全身抗瘤免疫力.
需要进一步的前性研究来验证这些发现.

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