免疫学和治疗策略在卵巢癌
Che-Wei Chang1, Szu-Ting Yang1, Peng-Hui Wang2
1Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Taiwanese journal of obstetrics & gynecology
|March 11, 2026
概括
免疫疗法与化疗相结合显著改善了对抗性卵巢癌 (PR-OC) 的存活率. 生物标志物可以动态预测反应,指导针对这种致命的妇科恶性瘤的个性化治疗策略.
科学领域:
- 妇科瘤学 妇科瘤学
- 免疫治疗是一种免疫疗法.
- 翻译研究是翻译研究.
背景情况:
- 表皮卵巢癌 (OC) 的复发率很高,而抗性OC (PR-OC) 是一个重大的临床挑战.
- 目前的管理通常依赖于无区间 (PF-I),但"两种疾病"框架承认不同的疾病过程和生物学定义的子组.
- 免疫疗法 (IOT) 正从单一疗法转向组合策略,以克服瘤微环境 (TME) 中的免疫抑制.
研究的目的:
- 为了评估添加pembrolizumab在抗性卵巢癌患者的标准化疗中的疗效.
- 探索生物标志物的作用,如PD-L1表达,在预测治疗反应.
- 推进生物知情,个性化治疗方法,治疗复发性OC.
主要方法:
- 在ENGOT-ov65/KEYNOTE-B96的III期试验中,研究了pembrolizumab加上每周一次的paclitaxel,有或没有bevacizumab,在患有PR-OC的患者中.
- 总生存率 (OS) 和无进展生存率 (PFS) 是关键终点.
- 进行了生物标记分析,包括PD-L1表达.
主要成果:
- 添加pembrolizumab显著改善了PD-L1表达PR-OC的患者和治疗意图 (ITT) 群体的整体存活率 (OS).
- 组合疗法在不同治疗线路中表现出有效性,挑战了仅仅依赖PF-I.
- 像PD-L1这样的生物标志物显示动态上调,受治疗的影响,表明一种补偿性免疫逃避状态.
结论:
- 基于免疫检查点抑制剂 (ICI) 的疗法在治疗PR-OC方面取得了重大进展,提供了改善的OS.
- 整合IOT的个性化治疗策略应考虑动态生物标志物和特定疾病背景.
- 未来的研究需要采用双向实验室对试验的方法,以根据卵巢癌不断变化的免疫环境量身定制疗法.
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