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在免疫检查点抑制期间,NSCLC患者的放射疗法在免疫检查点抑制期间发展为进展性疾病:无回应和生存率

Justus Kaufmann¹, Maike Trommer^2,3,4,5, Alexander Rühle^6,7

¹University Medical Center of the Johannes Gutenberg University, Department of Radiation Oncology, Mainz, Germany.

Clinical and translational radiation oncology

|March 12, 2026

概括

辐射疗法 (RT) 与免疫检查点抑制剂 (ICI) 结合,可以在非小细胞肺癌 (NSCLC) 患者中诱导abscopal反应 (AR). 年龄较大与更高的AR率有关,而更好的ECOG得分和寡头转移性疾病改善了整体存活率.

科学领域:

在瘤学瘤学.
免疫治疗是一种免疫疗法.
辐射瘤学辐射瘤学

背景情况:

放射治疗 (RT) 和免疫检查点抑制剂 (ICI) 显示出协同作用的抗瘤免疫反应.
随着RT和ICI治疗的结合,越来越多地观察到非辐射病变回归的abscopal反应 (AR).
在接受RT和ICI的非小细胞肺癌 (NSCLC) 患者中了解影响AR的因素至关重要.

研究的目的:

分析在接受RT和ICI治疗的NSCLC患者中abscopal反应 (AR) 的频率.
为了确定与AR相关的因素,在这个患者队列中,abscopal益处 (AB) 和整体存活率 (OS).

主要方法:

一项多中心的回顾性研究 (ARTIC) 分析了56名在ICI治疗期间或之后接受RT治疗的NSCLC患者的疾病进展情况.
患者按非辐射损伤反应分类.
使用后勤和考克斯回归模型来确定与AR,AB和OS相关的因素.

主要成果:

56名患者中有15名 (26.8%) 在至少一个非辐射病变中经历了AR.
年龄较大 (OR:1.07) 与AR的发病率较高有关,而男性则呈现增加AR风险的趋势 (OR:3.13).
改善的生存状况与更好的ECOG绩效得分 (HR:0.29) 和小卵性转移性疾病 (HR:0.34) 显著相关.

结论:

在ICI进展的NSCLC患者中,RT可以诱导AR,这可能会延迟需要进行全身治疗更改的需要.
在老年患者和男性中,abscopal (AB) 的益处较少.
在这种情况下,ECOG表现状况和寡头转移性疾病是改善存活率的关键预测因素.

关键词:

绝对的效果绝对的效果免疫治疗是一种免疫疗法.在NSCLCLC中,我们可以看到NSCLCLC.非小细胞肺癌是非小细胞肺癌.辐射疗法辐射疗法

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