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转移性细胞癌中的免疫疗法再挑战:随机临床试验的元分析

Hatice Bolek^1,2, Satı Coskun Yazgan^1,2, Emre Yekedüz^1,2,3

¹Department of Medical Oncology, Ankara University School of Medicine, Ankara, TÜRKİYE.

|December 26, 2025

概括

在转移性细胞癌 (mRCC) 中,使用PD-1/PD-L1抑制剂再加VEGF TKIs进行挑战,不会改善先前免疫检查点抑制剂 (ICI) 治疗后的存活率. 这种策略不应用于ICI治疗进展的患者.

科学领域:

在瘤学瘤学.
免疫治疗是一种免疫疗法.
细胞癌研究细胞癌研究

背景情况:

免疫检查点抑制剂 (ICI) 组合疗法在一线转移性细胞癌 (mRCC) 治疗中越来越多地使用,需要了解最佳后续治疗策略.
关于在初步进展后重新使用ICI疗法的疗效和结果的问题出现了.

研究的目的:

为了评估添加PD-1/PD-L1抑制剂的有效性,与VEGF TKI单疗相比,重新挑战血管内皮生长因子 (VEGF) 氨酸激酶抑制剂 (TKI).
评估mRCC患者的生存结果,这些患者先前接受了基于ICI的治疗.

主要方法:

通过使用两项III期随机对照试验 (CONTACT-03和TiNivo-2) 的数据进行了元分析.
该分析包括865名患有mRCC的患者,这些患者在之前基于ICI的组合治疗或单一治疗中进展.

主要成果:

在ICI加VEGFTKI组合组和TKI单疗组之间没有观察到无进展生存的显著差异 (HR=0.96,95%CI:0.76-1.21,p=0.75).
在抗VEGF TKI治疗中添加ICI再挑战并没有改善整体存活率 (HR=1.06,95%CI:0.89-1.25,p=0.52).

结论:

与VEGF TKI相结合的PD-1/PD-L1抑制剂再挑战并没有提高在ICI上先前进展的mRCC患者的生存结果.
这种组合疗法不应该给以前在ICI治疗中进展的患者.
对ICI治疗的内在和获得性耐药机制的进一步研究对于在RCC中开发改进的初始和后续免疫治疗策略至关重要.

关键词:

在 CTLA-4 中.在PD-1中使用PD-1.在PD-L1中.免疫疗法免疫疗法细胞癌瘤是细胞癌.铁氨基激酶抑制剂铁氨基激酶抑制剂

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