[对于肌肉侵入性膀癌的外科手术期免疫检查点抑制剂治疗的当前发展]
1Dept. of Urology, Kyoto University Graduate School of Medicine.
Gan to kagaku ryoho. Cancer & chemotherapy
|January 19, 2026
概括
使用免疫检查点抑制剂 (ICI) 的外科免疫疗法在肌肉侵入性膀癌 (MIBC) 方面表现有前途. 循环瘤DNA (ctDNA) 可以指导个性化治疗选择,以改善结果.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 膀癌研究 膀癌研究
背景情况:
- 肌肉侵入性膀癌 (MIBC) 的复发率很高.
- 标准治疗 (基于cisplatin的新辅助化疗 + 激进囊切除术) 不适合所有患者.
- 需要辅助策略来改善手术后的结果.
研究的目的:
- 在MIBC中审查围手术期免疫检查点抑制剂 (ICI) 治疗的关键III期试验.
- 讨论循环瘤DNA (ctDNA) 在指导外科手术期免疫治疗中的作用.
- 探索基于生物标志物,个性化的术后治疗方法的潜力.
主要方法:
- 在MIBC中评估术后ICI治疗的III期临床试验的综述.
- 对来自CheckMate 274,IMvigor010和NIAGARA等试验的数据进行分析.
- 检查循环瘤DNA (ctDNA) 作为预测生物标记物的实用性.
主要成果:
- 辅助尼沃卢马布在MIBC中改善了无病生存期 (DFS),特别是在PD-L1阳性患者中 (CheckMate 274).
- 辅助性阿特佐利祖马布在ctDNA阳性患者中显示出益处 (IMvigor010亚分析).
- 新辅助剂格美西塔-西斯普拉丁加上杜尔瓦卢马布,接着是辅助剂杜尔瓦卢马布,改善了DFS,整体存活率 (OS) 和pCR率 (NIAGARA).
结论:
- 术后ICI疗法代表了MIBC治疗的重大进展.
- 循环瘤DNA (ctDNA) 是风险分层和治疗选择的有希望的生物标志物.
- 未来的MIBC治疗可能会转向个性化,基于生物标志物的术后免疫疗法.
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