在头部和部癌症中新辅助免疫疗法和化学免疫疗法方案:系统性审查和元分析
Hannah Q Baratz1, Cecelia Hidalgo1, Daniel L Price1
1Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota.
JAMA otolaryngology-- head & neck surgery
|March 12, 2026
概括
与单独免疫疗法相比,新辅助化疗免疫疗法显著改善了头部和部状细胞癌 (HNSCC) 的病理反应率. 进一步的第三阶段试验是有必要的,以直接比较这些新辅助疗法.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 头部和部癌症研究研究
背景情况:
- 新辅助化疗免疫疗法在固体瘤中表现有前途,但其在头部和部状细胞癌 (HNSCC) 中的疗效需要进一步调查.
- 区域性先进的切除性HNSCC治疗正在以新的新辅助策略发展.
研究的目的:
- 在HNSCC中系统地审查和比较新辅助化疗免疫治疗与单独免疫治疗的疗效.
- 评估接受HNSCC新辅助治疗的患者的病理反应率和生存结果.
主要方法:
- 根据PRISMA指南进行了系统审查和元分析.
- 包括英语出版的可切除,未经治疗的HNSCC的未来干预试验.
- 主要结局包括主要病理反应 (MPR),完整病理反应 (CPR) 和RECIST 1.1反应;次要结局包括1年的整体存活率 (OS) 和毒性.
主要成果:
- 与双剂 (18%) 和单剂 (6%) 免疫疗法相比,新辅助化疗免疫疗法显示MPR加CPR的综合率 (66%) 显著更高.
- 在所有治疗组中,一年的OS率都很高 (88%-100%).
- 单剂免疫疗法的29%,双剂免疫疗法的3.0%,化学免疫疗法的17%报告了3-5级不良事件.
结论:
- 新辅助性化疗免疫治疗方案与局部区域先进的HNSCC中优异的病理和放射性反应率有关.
- 这些发现支持对头对头的第三期试验的必要性,以比较新辅助化学免疫疗法和免疫疗法方案.
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