ASCO2017:NSCLC患者一线化疗反应有望成为预测纳武单抗免疫治疗疗效的生物标志物

2017-05-20 艾兰博曼医学网 艾兰博曼医学网

纳武单抗(nivolumab )是靶向PD-1的单克隆抗体,用于二线治疗转移性非小细胞肺癌患者,而且20%的患者会从中获益。通过IHC方法对PD-1的配体PD-L1进行评估可以得到更好的结果。然而 ,目前为止仍缺乏有效预测的标志物。

纳武单抗(nivolumab )是靶向PD-1的单克隆抗体,用于二线治疗转移性非小细胞肺癌患者,而且20%的患者会从中获益。通过IHC方法对PD-1的配体PD-L1进行评估可以得到更好的结果。然而 ,目前为止仍缺乏有效预测的标志物。

研究人员纳入了来自于4个不同机构的115例IV期非小细胞肺癌(42例鳞状细胞癌,73例腺癌)患者。在至少经过一线铂类药物化疗后,对这些患者给予纳武单抗 (3 mg/kg IV Q2W) 治疗。一线化疗的效果和对于纳武单抗治疗的反应有CT片进行诊断。用Chi2和Cox分析一线化疗与无进展生存期(PFS)、OS或纳武单抗相应之间的关系。

研究结果表明,46例(40%),44例(38%)和25例(22%)患者在一线铂类化疗时发生了PR,SD和PD。25例(22%),34例(29.5%),56例(48.5%)患者在接受纳武单抗治疗时发生了PR,SD和PD。从化疗中获益的59.5% (53/89)患者(SD+PR)在同样会在纳武单抗的治疗过程中收益。而只有20%的PD患者会在纳武单抗的后续治疗中产生获益(Chi2检验 p = 0.002)。一线双联化疗的类型并不应下个纳武单抗治疗的响应率。Cox单因素和多变量模型分析发现尽管年龄、组织学和形态学的改变各异,从化疗中获益的患者在接受纳武单抗治疗时PFS(P = 0.002)(一线化疗后PR,SD,PD患者的nivolumab方案中位PFS为4.9,3.3和1.8个月)的生存期得到改善。同时,总生存期OS(P = 0.03)也得到了改善。

研究结论认为,对一线化疗的反应可能是NSCLC患者接受纳武单抗治疗预测PFS和OS良好的生物标志物。


原始出处:

Coureche Guillaume Kaderbhai, Corentin Richard, et al. Response to first-line chemotherapy regimen to predict efficacy of nivolumab in lung cancer. 2017 ASCO Annual Meeting Abstract No:3026

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    2017-06-01 quxin068
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  5. 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style='color:#2F92EE;'>#NSCLC患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13077, encryptionId=a4ed130e7d0, topicName=NSCLC患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=06332789533, createdName=xiongliangxl, createdTime=Mon May 22 12:01:00 CST 2017, time=2017-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1560607, encodeId=78c5156060e77, content=<a href='/topic/show?id=3c746936567' target=_blank style='color:#2F92EE;'>#生物标志#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69365, encryptionId=3c746936567, topicName=生物标志)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=63db15173977, createdName=zhu_jun9842, createdTime=Mon May 22 12:01:00 CST 2017, time=2017-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1566616, encodeId=d85415666163d, content=<a href='/topic/show?id=3c746936567' target=_blank style='color:#2F92EE;'>#生物标志#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69365, encryptionId=3c746936567, topicName=生物标志)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=63db15173977, createdName=zhu_jun9842, createdTime=Mon May 22 12:01:00 CST 2017, time=2017-05-22, status=1, ipAttribution=)]
    2017-12-01 jklm09
  6. 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style='color:#2F92EE;'>#NSCLC患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13077, encryptionId=a4ed130e7d0, topicName=NSCLC患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=06332789533, createdName=xiongliangxl, createdTime=Mon May 22 12:01:00 CST 2017, time=2017-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1560607, encodeId=78c5156060e77, content=<a href='/topic/show?id=3c746936567' target=_blank style='color:#2F92EE;'>#生物标志#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69365, encryptionId=3c746936567, topicName=生物标志)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=63db15173977, createdName=zhu_jun9842, createdTime=Mon May 22 12:01:00 CST 2017, time=2017-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1566616, encodeId=d85415666163d, content=<a href='/topic/show?id=3c746936567' target=_blank style='color:#2F92EE;'>#生物标志#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69365, encryptionId=3c746936567, topicName=生物标志)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=63db15173977, createdName=zhu_jun9842, createdTime=Mon May 22 12:01:00 CST 2017, time=2017-05-22, status=1, ipAttribution=)]
    2017-06-07 jacob9231

    学习了,谢谢分享

    0

  7. 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    2017-05-23 大爰

    学习了谢谢分享!!

    0

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Lancet Oncol:Pembrolizumab获批一线联合化疗治疗晚期NSCLC(KEYNOTE-021)

2017年5月10日,美国FDA加速批准了Pembrolizumab(Keytruda)联合培美曲塞+卡铂用于既往未经治疗的无突变的晚期NSCLC患者(非鳞癌)的治疗。这项适应症的获批使得Keytruda的说明书再次更新(之前的一次是2017年02月份的更新),而且把免疫单抗对于肺癌的治疗带入了一个新阶段,即联合化疗的全新治疗模式。该适应症的批准是基于一项名为KEYNOTE-021的多中心、开放、

FDA批准pembrolizumab作为高表达PD-L1转移性NSCLC的一线治疗

FDA批准pembrolizumab作为表达PD-L1的转移性非小细胞肺癌的一线治疗药物。该药物适用于无EGFR或ALK基因异常、高PD-L1表达(肿瘤比例分数50%)和之前没有接受系统化疗的转移性非小细胞肺癌患者。剂量为每三周200毫克,直至疾病进展、出现不可接受的毒性、或24个月患者无疾病进展。两项随机对照试验表明,随机分配到pembrolizumab组的患者与化疗组患者相比,PFS和OS均得