Hypofractionated radiotherapy plus PD-1 antibody and SOX chemotherapy as second-line therapy in metastatic pancreatic cancer: a single-arm, phase II clinical trial.

IF 4.6 2区 医学 Q2 IMMUNOLOGY Cancer Immunology, Immunotherapy Pub Date : 2024-08-06 DOI:10.1007/s00262-024-03744-z
Qin Wang, Fan Tong, Li Qiao, Liang Qi, Yi Sun, Yahui Zhu, Jiayao Ni, Juan Liu, Weiwei Kong, Baorui Liu, Juan Du
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Abstract

Purpose: To assess the efficacy and safety of concurrent hypofractionated radiotherapy plus anti-PD-1 antibody and SOX chemotherapy in the treatment of metastatic pancreatic cancer (mPC) after failure of first-line chemotherapy.

Methods: Patients with pathologically confirmed mPC who failed standard first-line chemotherapy were enrolled. The patients were treated with a regimen of hypofractionated radiotherapy, SOX chemotherapy, and immune checkpoint inhibitors at our institution. We collected the patients' clinical information and outcome measurements. The median progression-free survival (mPFS) was the primary endpoint of the study, followed by disease control rate (DCR), objective response rate (ORR), median overall survival (mOS) and safety. Exploratory analyses included biomarkers related to the benefits.

Results: Between February 24, 2021, and August 30, 2023, twenty-five patients were enrolled in the study, and twenty-three patients who received at least one dose of the study agent had objective efficacy evaluation. The mPFS was 5.48 months, the mOS was 6.57 months, and the DCR and ORR were 69.5% and 30.4%, respectively. Among the seven patients who achieved a PR, the median duration of the response was 7.41 months. On-treatment decreased serum CA19-9 levels were associated with better overall survival. Besides, pretreatment inflammatory markers were associated with tumor response and survival.

Conclusions: Clinically meaningful antitumor activity and favorable safety profiles were demonstrated after treatment with these combination therapies in patients with refractory mPC. On-treatment decreased serum CA19-9 levels and pretreatment inflammatory markers platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), lactate dehydrogenase (LDH) might be biomarkers related to clinical benefits.

Clinical trial registration: https://www.chictr.org.cn/showproj.html?proj=130211 , identifier: ChiCTR2100049799, date of registration: 2021-08-09.

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转移性胰腺癌二线治疗中的低分次放疗加 PD-1 抗体和 SOX 化疗:单臂 II 期临床试验。
目的:评估低分次放疗联合抗PD-1抗体和SOX化疗治疗一线化疗失败后的转移性胰腺癌(mPC)的有效性和安全性:入选患者均为病理确诊的转移性胰腺癌患者,且一线化疗失败。这些患者在我院接受了低分次放疗、SOX化疗和免疫检查点抑制剂治疗。我们收集了患者的临床信息和疗效测量结果。中位无进展生存期(mPFS)是研究的主要终点,其次是疾病控制率(DCR)、客观反应率(ORR)、中位总生存期(mOS)和安全性。探索性分析包括与获益相关的生物标志物:2021年2月24日至2023年8月30日期间,共有25名患者入组研究,23名接受了至少一剂研究药物的患者进行了客观疗效评估。mPFS为5.48个月,mOS为6.57个月,DCR和ORR分别为69.5%和30.4%。在获得 PR 的 7 名患者中,中位反应持续时间为 7.41 个月。治疗时血清CA19-9水平的降低与较好的总生存率相关。此外,治疗前的炎症标志物与肿瘤反应和生存期有关:结论:对于难治性mPC患者,这些联合疗法具有临床意义的抗肿瘤活性和良好的安全性。治疗时血清CA19-9水平的降低和治疗前炎症标志物血小板与淋巴细胞比值(PLR)、淋巴细胞与单核细胞比值(LMR)、乳酸脱氢酶(LDH)可能是与临床获益相关的生物标志物。临床试验注册:https://www.chictr.org.cn/showproj.html?proj=130211 ,标识符:ChiCTR2100049799:ChiCTR2100049799,注册日期:2021-08-09。
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来源期刊
CiteScore
10.50
自引率
1.70%
发文量
207
审稿时长
1 months
期刊介绍: Cancer Immunology, Immunotherapy has the basic aim of keeping readers informed of the latest research results in the fields of oncology and immunology. As knowledge expands, the scope of the journal has broadened to include more of the progress being made in the areas of biology concerned with biological response modifiers. This helps keep readers up to date on the latest advances in our understanding of tumor-host interactions. The journal publishes short editorials including "position papers," general reviews, original articles, and short communications, providing a forum for the most current experimental and clinical advances in tumor immunology.
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