在晚期细胞癌中对尼沃卢马布加上伊皮利穆马布的初级耐药性进行治疗前预测因素:一个多中心合作研究
Kimihiko Masui1, Naoki Hayata2, Toshinari Yamasaki3
1Department of Urology, Kyoto University Graduate School of Medicine, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan.
Japanese journal of clinical oncology
|January 9, 2026
概括
类细胞分化和乳酸脱酶 (LDH) 的升高预测了晚期细胞癌 (RCC) 中对nivolumab加上ipilimumab的初级耐药性. 为患有这些因素的患者考虑替代治疗方法.
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:
- 尼沃卢马布加上伊皮利穆马布是治疗晚期细胞癌 (RCC) 的一线治疗方法.
- 对这种组合疗法的初级耐药性可能会限制治疗的疗效.
- 确定原发性耐药性的预测因素对于优化患者管理至关重要.
研究的目的:
- 确定与高级RCC中对尼沃卢马布加上伊皮利穆马布的初级耐药性相关的预治疗因素.
- 为了确定预测RCC患者治疗反应的潜在生物标志物.
主要方法:
- 从89名先进RCC患者的临床,实验室和瘤数据的回顾性审查,这些患者接受一线尼沃卢马布加上伊皮利穆马布.
- 主要耐药性定义为在3个月内进展;伪进展病例被排除在外.
- 进行了单变量和多变量分析,以确定预测因素,包括肉类类分化和血清乳酸脱酶 (LDH).
主要成果:
- 在89名患者中,23名患者 (25.8%) 呈现初级耐药性.
- 类细胞分化 (OR,4.264) 和血清LDH升高≥174U/L (OR,3.634) 被确定为初级耐药性的独立预测因素.
- 其他因素,如BMI,淋巴结转移,单个转移器官和肝转移,在单变量分析中显示出相关性.
结论:
- 治疗前的肉类类分化和血清LDH升高是高级RCC中对尼沃卢马布加上伊皮利穆马布的初级耐药性的显著预测因素.
- 这些发现表明,具有这些特征的患者可能从替代治疗策略中受益.
- 早期识别耐药性可以指导高级RCC的个性化治疗决策.
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