结合免疫疗法和/或针对晚期胆道癌的向治疗的动脉内治疗:一项回顾性研究
Mengjie Li1, Shaoqiang Yuan1, Jia Zhan2
1Graduate School, The First Clinical Medical College of Nanchang University, Nanchang, Jiangxi Province, China.
Medicine
|December 23, 2025
概括
内动脉治疗 (IAT) 与抗编程细胞死亡蛋白1 (PD-1) 免疫疗法和氨酸激酶抑制剂 (TKIs) 结合,在晚期胆道癌 (BTC) 中改善了无进展生存率. 淋巴结转移是高级BTC患者的关键预后因素.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 干预性放射学 干预性放射学
背景情况:
- 晚期胆道癌 (BTC) 存在重大治疗挑战.
- 目前的治疗策略通常涉及全身化疗,氨酸激酶抑制剂 (TKI) 和抗编程细胞死亡蛋白1 (PD-1) 免疫疗法.
- 动脉内治疗 (IAT) 为局部药物输送提供了有针对性的方法.
研究的目的:
- 为了比较高级BTC不同治疗组合的疗效和安全性.
- 具体来说,要评估与TKIs结合的抗PD-1免疫疗法以及IAT或全身化疗.
- 此外,评估与IAT或全身化疗相结合的抗PD-1免疫疗法.
主要方法:
- 对接受IAT或全身化疗结合抗PD-1免疫疗法和/或TKI的高级BTC患者的回顾性分析.
- 患者被分为四组:IAT + TKIs + 抗PD-1 (ITP),化疗 + TKIs + 抗PD-1 (CTP),IAT + 抗PD-1 (IP) 和化疗 + 抗PD-1 (CP).
- 无进展生存率 (PFS),客观应答率 (ORR),疾病控制率 (DCR) 和不良事件的比较;对PFS进行风险因素分析.
主要成果:
- 与CTP组 (3.285个月) 相比,ITP组的PFS中位数显著更长 (3.975个月).
- 试验期组的PFS中位数 (4,534个月) 与CP组 (2,267个月) 相比,IP组的PFS中位数也明显长.
- 淋巴结转移被确定为影响PFS的独立风险因素;在IAT组中观察到发烧和排尿困难的发病率增加.
结论:
- 与抗PD-1免疫疗法和TKI相结合的IAT,或单独使用抗PD-1免疫疗法的IAT,对于高级BTC来说似乎相对有效和安全.
- 与基于全身化疗的组合相比,基于IAT的组合可能会提供更好的无进展生存率.
- 识别淋巴结转移对于预测晚期BTC患者的预后至关重要.
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