对客观反应率和生存终点的基于模型的元分析,以比较非小细胞肺癌中PD-1和PD-L1治疗结果
Richard C Franzese1, Li Qin2, Shuai Fu2
1Clinical Pharmacology Modeling and Simulation, GSK, Upper Providence, Pennsylvania, USA.
CPT: pharmacometrics & systems pharmacology
|February 19, 2026
概括
客观反应率 (ORR) 显著预测了转移性非小细胞肺癌 (mNSCLC) 治疗PD-L) 1抑制剂的生存结果. 虽然PD-1抑制剂比PD-L1抑制剂具有数值优势,但差异在统计学上并不显著.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 临床试验设计 临床试验设计
背景情况:
- 编程细胞死亡 (PD) -L) 1 抑制剂是转移性非小细胞肺癌 (mNSCLC) 的标准治疗方法.
- 在临床开发中,无进展生存率 (PFS) 和客观响应率 (ORR) 经常被用作总生存率 (OS) 的替代终点.
- 在用PD-L) 1抑制剂治疗的mNSCLC中存在ORR,PFS和OS之间的一致性.
研究的目的:
- 评估PD-(L) 1抑制剂对mNSCLC疗效的影响.
- 探索ORR和生存终点 (OS和PFS) 之间的关系.
- 为了比较PD-1与PD-L1抑制剂在mNSCLC中的疗效.
主要方法:
- 114项研究的连续两阶段基于模型的元分析 (MBMA).
- 混合效应后勤回归用于评估ORR的治疗效应和共变量.
- 混合效应的半参数比例危险模型使用OS和PFS的数字化Kaplan-Meier曲线,将ORR纳入预测器.
主要成果:
- 客观应答率 (ORR) 是总生存率 (OS) 和无进展生存率 (PFS) 的重要预测指标.
- 模拟的头对头比较表明,PD-1抑制剂比PD-L1抑制剂更受青的数值趋势,但这些差异缺乏统计学意义.
- 该研究确立了ORR和生存结果之间的强有力的关系,考虑到各种变异源.
结论:
- 客观反应率 (ORR) 是可靠的替代品,用于预测mNSCLC患者的生存结果,这些患者接受PD-(L) 1抑制剂治疗.
- 结果支持使用早期阶段试验的ORR数据来告知后期试验设计和新兴疗法的基准.
- 该研究通过量化ORR的预测价值为mNSCLC临床开发提供了基于证据的决策框架.
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