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Eur Urol:转移肾细胞癌的一线肿瘤免疫联合疗法疗效分析

2019-09-02 AlexYang MedSci原创

在转移性肾细胞癌(mRCC)中,近期的数据显示了一线药物易普利姆玛与纳武单抗(ipi-nivo)联合和免疫肿瘤(IO)/血管内皮生长因子(VEGF)抑制剂联合治疗的疗效情况。但是这些治疗策略之间的比较性数据仍旧有限。最近,有研究人员比较了ipi-nivo与IO-VEGF (IOVE)在mRCC中的疗效比较情况,并阐释了实践模式和二线疗法的疗效情况。研究总共有113名患者接受了IOVE联合疗法,75

在转移性肾细胞癌(mRCC)中,近期的数据显示了一线药物易普利姆玛与纳武单抗(ipi-nivo)联合和免疫肿瘤(IO)/血管内皮生长因子(VEGF)抑制剂联合治疗的疗效情况。但是这些治疗策略之间的比较性数据仍旧有限。

最近,有研究人员比较了ipi-nivo与IO-VEGF (IOVE)在mRCC中的疗效比较情况,并阐释了实践模式和二线疗法的疗效情况。研究总共有113名患者接受了IOVE联合疗法,75名患者接受了ipi-nivo联合疗法。研究发现,对IOVE联合疗法和ipi-nivo联合疗法,一线响应速度为分别为33%和40%(差异7%, 95%置信区间[CI] -8%到22%, p=0.4),治疗失败时间(TTF)分别为14.3和10.2 mo(p=0.2),下次治疗时间(TNT)分别为19.7和17.9 mo (p=0.4),总生存(OS)不成熟且没有统计学显著差异(p=0.17)。另外,TTF、TNT和OS的调整后风险比分别为0.71 (95%CI 0.46-1.12, p=0.14)、0.65 (95%CI 0.38-1.11, p=0.11)和1.74 (95% CI 0.82-3.68, p=0.14)。64名患者(34%)接受了二线治疗。在随后接受基于VEGF治疗的患者中,二线响应速度在IOVE患者群体中要比ipi-nivo群体更低(15% vs 45%; 组间差异30%, 95%CI 3-57%, p=0.04; n=40),而在二线药物TTF在两组之间差异不显著(3.7 vs 5.4 mo; p=0.4; n=55)。研究人员指出了限制性因素包括了研究的回顾性设计和样本大小。

最后,研究人员指出,一线药物IOVE和ipi-nivo之间的疗效没有显著的差异。大多数患者接受了基于VEGF的二线药物治疗。在他们的研究群体中,二线药物响应速度在起始接受ipi-nivo的患者中更高。

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    2019-09-02 内科新手

    谢谢梅斯提供这么好的信息,学到很多

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