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Lancet:Pembrolizumab治疗复发或转移性头颈部鳞状细胞癌

2019-11-04 MedSci MedSci原创

PD-L1单抗Pbrobrolizumab对头颈部鳞状细胞癌(HNSCC)中具有较好的活性,近日研究人员公布了III期临床KEYNOTE-048的研究结果。 未经治疗的局部复发或转移性HNSCC患者参与研究,根据PD-L1表达、P16状态和性能状态进行分层,随机接受Pembrolizumab治疗、Pembrolizumab+铂和5-氟尿嘧啶(Pembrolizumab-化疗)或西妥昔单抗+铂

PD-L1单抗Pbrobrolizumab对头颈部鳞状细胞癌(HNSCC)中具有较好的活性,近日研究人员公布了III期临床KEYNOTE-048的研究结果。

未经治疗的局部复发或转移性HNSCC患者参与研究,根据PD-L1表达、P16状态和性能状态进行分层,随机接受Pembrolizumab治疗、Pembrolizumab+铂和5-氟尿嘧啶(Pembrolizumab-化疗)或西妥昔单抗+铂和5-氟尿嘧啶(西妥昔单抗联合化疗)。研究的主要终点是总生存期和无进展生存期。

882名患者参与研究,其中301人接受单独Pembrolizumab治疗,281人接受Pembrolizumab化疗,300人接受西妥昔单抗化疗。754人(85%)CPS1分以上,381人(43%)20分以上。研究发现,对于CPS20以上人群,单独的Pembrolizumab治疗,较西妥昔单抗化疗,患者总生存期得到显著改善(14.9 vs 10.7个月,HR=0.61),在CPS1以上人群中,效果也十分显著(HR=0.78),但对全部人群的疗效较低(HR=0.85)。Pembrolizumab化疗可改善全部患者的总生存期(13.0 vs 10.7个月,HR=0.77),对CPS20以及1以上人群的效果也较为明显。Pembrolizumab单药或Pembrolizumab化疗均不能改善患者的无进展生存期。Pembrolizumab、Pembrolizumab化疗以及西妥昔单抗化疗人群3级及以上不良事件发生率分别为55%、85%以及83%,不良事件死亡率分别为8%、12%以及10%。

研究认为,Pembrolizumab化疗应成为复发或转移性头颈部鳞状细胞癌的一线治疗手段,而Pembrolizumab可作为PDL1阳性患者的首选治疗方案。

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    2020-06-05 feather89
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    2020-08-21 howi
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time=2019-11-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1589814, encodeId=68a31589814dc, content=<a href='/topic/show?id=124d10065220' target=_blank style='color:#2F92EE;'>#颈部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100652, encryptionId=124d10065220, topicName=颈部)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c46a17776631, createdName=木头人519, createdTime=Wed Nov 06 08:49:00 CST 2019, time=2019-11-06, status=1, ipAttribution=)]
    2019-11-25 chendoc242
  5. 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time=2019-11-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1589814, encodeId=68a31589814dc, content=<a href='/topic/show?id=124d10065220' target=_blank style='color:#2F92EE;'>#颈部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100652, encryptionId=124d10065220, topicName=颈部)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c46a17776631, createdName=木头人519, createdTime=Wed Nov 06 08:49:00 CST 2019, time=2019-11-06, status=1, ipAttribution=)]
    2020-05-13 snf701207
  6. 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  7. 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    2019-11-06 wshxjq
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程序性死亡配体1(PD-L1)和细胞毒性T淋巴细胞相关蛋白4(CTLA-4)的双重阻断可以克服免疫检查点抑制。复发或转移性头颈部鳞状细胞癌(R / M HNSCC)且肿瘤PD-L1低表达的患者进行双重阻断是否可以增强抗肿瘤活性且不损害安全性尚不清楚。JAMAONCOL近期发表了一篇文章,研究durvalumab联合tremelimumab的安全性和客观缓解率。

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