针对KRAS突变亚型的第一线免疫化学疗法的有效性在晚期肺腺癌中
Hongping Jin1, Honglei Huang2, Yiqing Wu1
1Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
International journal of cancer
|February 4, 2026
概括
第一线免疫化学疗法在患有不同KRAS突变的晚期肺腺癌患者中表现出类似的有效性,无论PD-L1表达如何. STK11的共同突变与较差的结果有关.
科学领域:
- 在瘤学瘤学.
- 遗传学 是一个遗传学.
- 免疫治疗是一种免疫疗法.
背景情况:
- KRAS突变在肺腺癌 (LUAD) 中很常见.
- 特定的KRAS亚型对第一线免疫化学疗法的治疗反应的影响尚不清楚.
- 编程死亡配体1 (PD-L1) 表达和共变可能会影响治疗疗效.
研究的目的:
- 评估一线免疫化学疗法在先进的LUAD中对不同KRAS突变亚型的治疗疗效.
- 检查PD-L1表达和共突变在预测治疗反应中的作用.
主要方法:
- 对335名先进的KRAS突变LUAD患者进行了回顾性分析,这些患者接受了第一线免疫化学疗法.
- 基于KRAS亚型 (G12A,G12C,G12D,G12V等) 的患者分类.
- PD-L1瘤比例得分 (TPS) 的分层化和对共突变的评估,包括STK11.
主要成果:
- 总体中位数无进展生存 (PFS) 为8.6个月,客观应答率 (ORR) 为34.0%,疾病控制率 (DCR) 为87.8%.
- 在KRAS亚型或PD-L1TPS组之间没有观察到PFS的显著差异 (<1%,1-49%,≥50%).
- 在G12C,G12V和其他KRAS亚型中,STK11共同突变更频繁,并且与较短的PFS有关.
结论:
- 第一线免疫化学疗法在先进的LUAD中显示出不同KRAS突变亚型的可比疗效,无论PD-L1表达水平如何.
- PD-L1表达不能预测主要KRAS子组内的PFS.
- 在这种患者群体中,STK11共同突变是潜在的负预后因素.
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