European Journal of Cancer最新文献_第5页

Risk of pancreatic cancer after eradication treatment of Helicobacter pylori 根除幽门螺杆菌治疗后胰腺癌的风险

IF 7.1 1区医学 Q1 ONCOLOGY

European Journal of Cancer

Pub Date : 2025-12-18 DOI: 10.1016/j.ejca.2025.116192

Anna-Klara Wiklund , Giola Santoni , Cecilia Radkiewicz , Shaohua Xie , Helgi Birgisson , Eivind Ness-Jensen , My von Euler-Chelpin , Joonas H. Kauppila , Jesper Lagergren

Objectives

Helicobacter pylori infection seems to increase the risk of developing pancreatic cancer, but it is unknown whether eradication treatment of this bacterium changes this risk. We hypothesized that the increased risk of pancreatic cancer among individuals infected with Helicobacter pylori decreases over time after eradication treatment.

Methods

This multinational and population-based cohort study, using prospectively collected nationwide register data from 1995 to 2019, included all adults who received eradication treatment for Helicobacter pylori in Denmark, Finland, Iceland, Norway, or Sweden. Standardized incidence ratios (SIR) with 95 % confidence intervals (95 %CI) were calculated by dividing the incidence rates of pancreatic cancer in the eradication treatment cohort by that of the entire populations of the corresponding age, sex, calendar year, and country. The main outcome was changes in SIR over time after eradication treatment.

Results

During up to 24 years of follow-up of 661,827 participants and 5494,255 person-years in the eradication treatment cohort, 2331 participants developed pancreatic cancer. The risk of pancreatic cancer was increased during the first 1–5 years after eradication treatment (SIR 1.14, 95 % CI 1.07–1.21), after which it decreased and became similar to the level of the background population 6–10 years (SIR 0.99, 95 % CI 0.92–1.07) and 11–24 years (SIR 1.00, 95 % CI 0.92–1.08) after eradication treatment.

Conclusion

The elevated risk of developing pancreatic cancer among individuals with Helicobacter pylori infection seems to decrease after eradication treatment, reaching the risk estimates of the background population.

目的幽门螺杆菌感染似乎会增加患胰腺癌的风险，但目前尚不清楚根除这种细菌的治疗是否会改变这种风险。我们假设，幽门螺杆菌感染者胰腺癌风险的增加在根除治疗后随着时间的推移而降低。方法：这项以人群为基础的跨国队列研究，使用1995年至2019年期间前瞻性收集的全国登记数据，包括丹麦、芬兰、冰岛、挪威或瑞典接受幽门螺杆菌根除治疗的所有成年人。通过将根除治疗队列中胰腺癌的发病率除以相应年龄、性别、日历年和国家的整个人群的发病率，计算出具有95 %置信区间（95 %CI）的标准化发病率（SIR）。主要结果是根除治疗后SIR随时间的变化。结果在长达24年的随访中，661,827名参与者和根除治疗队列的5494,255人年，2331名参与者发展为胰腺癌。胰腺癌的风险在根除治疗后的前1-5年增加（SIR 1.14, 95 % CI 1.07-1.21），之后降低并与根除治疗后6-10年（SIR 0.99, 95 % CI 0.92-1.07）和11-24年（SIR 1.00, 95 % CI 0.92-1.08）的背景人群水平相似。结论幽门螺杆菌感染个体在根除治疗后发生胰腺癌的风险降低，达到背景人群的风险估计。

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引用次数: 0

Ambient air pollution and survival in SCLC/LCNEC: Analysis of a single centre retrospective cohort 环境空气污染与SCLC/LCNEC患者的生存：单中心回顾性队列分析。

IF 7.1 1区医学 Q1 ONCOLOGY

European Journal of Cancer

Pub Date : 2025-12-18 DOI: 10.1016/j.ejca.2025.116190

Luca Carlofrancesco Ammoni , Valentina Cortesi , Paolo Borghetti , Alice Baggi , Camilla Vultaggio , Vito Amoroso , Giorgio Facheris , Mattia Facchetti , Susanna Bianchi , Marta Laganà , Deborah Cosentini , Daniela Nonnis , Stefano Maria Magrini , Alfredo Berruti , Salvatore Grisanti

Background

Small cell lung cancer (SCLC) and large cell neuroendocrine carcinoma of the lung (LCNEC) are the deadliest forms of lung cancer with dismal prognosis. Recent evidence suggests that, beyond cigarette smoke, air pollution can have a role in the pathogenesis of non-small cell lung cancer (NSCLC) and is associated with poorer survival. However, whether air pollutants exposure could affect survival outcomes in SCLC/LCNEC is unknown.

Methods

We retrospectively analysed data from SCLC/LCNEC cases observed in the province of Brescia province Brescia between 2017 and 2021. Air pollutants mean concentrations were calculated during the same timeframe and the Brescia province was divided in six subareas dichotomized into lightly and heavily polluted areas based on the mean PM_2.5 concentrations. Primary endpoint was to determine the impact of air pollutants exposure on SCLC/LCNEC overall survival (OS). Additionally, we explored the distribution of SCLC/LCNEC across the subareas classified for different air pollutants concentrations.

Findings

We observed 221 cases of SCLC/LCNEC, accounting for about 18 % of new lung cancer cases. Residency in heavily polluted areas (HR 1.51, p = 0.03) and extensive stage disease at diagnosis (HR 2.47, p = 0.0001) emerged as independent factors for poorer survival. Exploratory analyses showed an association between the distribution of SCLC/LCNEC cases and higher PM₁₀ and NO₂ concentrations (OR 1.16, p < 0.001 and OR 1.46, p < 0.001, respectively).

Interpretation

These results indicate that long-term exposure to high levels of PM_2.5 represent an independent unfavourable prognostic factor for SCLC/LCNEC. Our data suggest that air pollution may also favour the onset of these malignant diseases. Case-control studies are warranted to confirm these preliminary results.

背景：小细胞肺癌（SCLC）和大细胞神经内分泌癌（LCNEC）是最致命的肺癌，预后较差。最近的证据表明，除了香烟烟雾，空气污染还可能在非小细胞肺癌（NSCLC）的发病机制中发挥作用，并与较差的生存率相关。然而，空气污染物暴露是否会影响SCLC/LCNEC患者的生存结局尚不清楚。方法：回顾性分析布雷西亚省2017年至2021年间观察到的SCLC/LCNEC病例数据。计算了同一时间段内空气污染物的平均浓度，并根据PM2.5的平均浓度将布雷西亚省划分为六个分区，分为轻污染区和重污染区。主要终点是确定空气污染物暴露对SCLC/LCNEC总生存期（OS）的影响。此外，我们还探讨了SCLC/LCNEC在不同空气污染物浓度分类的子区域中的分布。结果：我们观察到221例SCLC/LCNEC，约占肺癌新发病例的18% %。居住在重污染地区（HR 1.51, p = 0.03）和诊断时疾病分期广泛（HR 2.47, p = 0.0001）成为较差生存率的独立因素。探索性分析显示SCLC/LCNEC病例的分布与较高的PM10和NO2浓度之间存在关联（OR 1.16, p ）。解释：这些结果表明，长期暴露于高水平的PM2.5是SCLC/LCNEC的一个独立的不利预后因素。我们的数据表明，空气污染也可能有利于这些恶性疾病的发病。有必要进行病例对照研究来证实这些初步结果。

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引用次数: 0

The basis for future personalized therapy approaches – Machine learning-generated 1-year survival rate, metastatic status and therapy-dependent survival in pancreatic cancer patients 未来个性化治疗方法的基础——机器学习生成胰腺癌患者的1年生存率、转移状态和治疗依赖生存率。

IF 7.1 1区医学 Q1 ONCOLOGY

European Journal of Cancer

Pub Date : 2025-12-17 DOI: 10.1016/j.ejca.2025.116189

François Schneider , Haotian Chen , Uwe Pelzer , Richard G. Compton , Gregor Duwe , Mihnea P. Dragomir , Georg Hilfenhaus , Loredana Vecchione , Annabel Alig , Matthäus Felsenstein , Markus Lerchbaumer , Damian T. Rieke , Marcus Bahra , Ralf Kutsche , Kristina Tschulik , Sebastian Stintzing , Ulrich Keilholz , Christopher C.M. Neumann

Background

Pancreatic adenocarcinoma (PDAC) remains one of the most lethal types of cancer, characterized by its unspecific symptoms, aggressive nature and late-stage diagnosis.

Patients and methods

In this study, Machine Learning (ML) models were trained and applied on the largest international, monocentric database, comprising over 23 clinical variables from 1040 PDAC patients. In this study, the potential of ML models was assessed for the 1-year survival rate, metastatic M0/M1 status and therapy-dependent survival time generating predictive and prognostic ML-based biomarkers.

Results

Consistent predictive performance was achieved for the 1-year survival rate (accuracy, internal/external cohort 72 % / 70 %) and radiological metastatic M0/M1 status (Accuracy, internal/external cohort 79 % / 72 %). Moreover, distinct ML-based survival models were trained for approved first-line adjuvant and palliative chemotherapy regimen (mFOLFIRINOX, gemcitabine with or without nab-paclitaxel) across resected (C-index = 0.60), locally advanced (C-index = 0.71) and metastatic (C-index = 0.71) PDAC subgroups, demonstrating that predictive performance is best for palliative regimens.

Conclusions

The models developed in this study may serve as a foundation for supporting tumor board decisions and demonstrate that personalized, ML-based therapy concepts are feasible in the near future. In addition, the models proposed in this study are helpful for generating ML-based synthetic control arms in future clinical trials.

背景：胰腺腺癌（PDAC）仍然是最致命的癌症类型之一，其特点是症状不特异性，侵袭性和晚期诊断。患者和方法：在本研究中，机器学习（ML）模型在最大的国际单中心数据库上进行训练和应用，该数据库包含来自1040名PDAC患者的23个临床变量。在这项研究中，评估了ML模型的1年生存率、转移性M0/M1状态和治疗依赖生存时间的潜力，从而产生了基于ML的预测性和预后性生物标志物。结果：1年生存率（准确性，内部/外部队列72 % / 70 %）和放射转移M0/M1状态（准确性，内部/外部队列79 % / 72 %）达到一致的预测性能。此外，在切除（c -指数= 0.60）、局部晚期（c -指数= 0.71）和转移性（c -指数= 0.71）PDAC亚组中，针对已批准的一线辅助和姑息性化疗方案（mFOLFIRINOX、吉西他滨加或不加nab-紫杉醇），不同的基于ml的生存模型进行了培训，表明姑息性方案的预测性能最好。结论：本研究中建立的模型可以作为支持肿瘤委员会决策的基础，并证明个性化的、基于ml的治疗概念在不久的将来是可行的。此外，本研究提出的模型有助于在未来的临床试验中生成基于ml的合成对照臂。

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引用次数: 0

Letter re: Patient-related prognostic factors in older adults with head and neck cancer: The EGeSOR clinical trial" 信re：老年人头颈癌患者相关预后因素：EGeSOR临床试验”。

IF 7.1 1区医学 Q1 ONCOLOGY

European Journal of Cancer

Pub Date : 2025-12-17 DOI: 10.1016/j.ejca.2025.116169

Han-Jie Long, Gui Yang , Qi-Wei Liang

引用次数: 0

Response to letter Re: “Patient-related prognostic factors in older adults with head and neck cancer: The EGeSOR clinical trial”. 对Re：“老年头颈癌患者相关预后因素：EGeSOR临床试验”的回应。

IF 7.1 1区医学 Q1 ONCOLOGY

European Journal of Cancer

Pub Date : 2025-12-13 DOI: 10.1016/j.ejca.2025.116170

Charlotte Lafont, Elena Paillaud, Lydia Brugel, Florence Canouï-Poitrine

引用次数: 0

Cardiotoxic effects of BRAF/MEK inhibition: An observational study BRAF/MEK抑制的心脏毒性作用：一项观察性研究

IF 7.1 1区医学 Q1 ONCOLOGY

European Journal of Cancer

Pub Date : 2025-12-12 DOI: 10.1016/j.ejca.2025.116182

Jannek Brauer , Daniel Scheidet , Sebastian Romann , Christina Zehender , Jessica Hassel , Norbert Frey , Lorenz H. Lehmann

Background

BRAF/MEK inhibitors are a cornerstone of the therapy of BRAF-mutant cancers. Despite frequent use, the incidence of cardiovascular side effects is still unclear. Data on cancer therapy-related cardiac dysfunction (CTRCD), particularly using contemporary biomarker-inclusive definitions, remain limited.

Objectives

To assess the incidence and risk factors of CTRCD in patients receiving BRAF/MEK inhibitors, using the International Cardio-Oncology Society (ICOS) definitions, which include cardiac imaging and biomarker assessments.

Methods

A total of 75 patients treated with BRAF/MEK inhibitors underwent prospective cardiotoxicity monitoring with two follow-up visits at 90 days (IQR 36–137 days) and 199 days (IQR 115–266 days). Standardized evaluations included echocardiography with global longitudinal strain (GLS), high-sensitivity cardiac troponin T (hs-cTnT), and NT-proBNP measurements at baseline and follow-up visits. CTRCD was classified according to ICOS criteria. Baseline risk was stratified by European Society of Cardiology (ESC) risk categories.

Results

CTRCD occurred in 33 of 75 patients (44 %), with 17 % classified as mild, 23 % moderate, and 4 % severe. Baseline age, sex, BMI, and most cardiovascular risk factors were not significantly associated with CTRCD. Coronary artery disease was the only baseline variable associated with increased CTRCD (OR 11.0, p = 0.029; univariate analysis), whereas elevated hs-cTnT, NT-proBNP, or reduced LVEF at baseline were not predictive. Absolute CTRCD numbers were highest in the high ESC-defined cardiovascular risk category group, while incidence peaked in the low-risk group. Other cardiac complications occurred in 41 patients (55 %).

Conclusions

CTRCD is frequent among patients treated with BRAF/MEK inhibitors. Traditional cardiovascular risk factors were not predictive, although coronary artery disease emerged as a strong risk marker. These findings highlight the need for dynamic surveillance strategies.

braf /MEK抑制剂是braf突变型癌症治疗的基础。尽管频繁使用，心血管副作用的发生率仍不清楚。关于癌症治疗相关心功能障碍（CTRCD）的数据，特别是使用当代生物标志物包容性定义的数据仍然有限。目的利用国际心脏肿瘤学会（ICOS）的定义，包括心脏成像和生物标志物评估，评估接受BRAF/MEK抑制剂的患者CTRCD的发生率和危险因素。方法对75例接受BRAF/MEK抑制剂治疗的患者进行前瞻性心脏毒性监测，并在90天（IQR 36-137天）和199天（IQR 115-266天）进行两次随访。标准化评估包括超声心动图总体纵向应变（GLS），高灵敏度心肌肌钙蛋白T (hs-cTnT)，以及基线和随访时的NT-proBNP测量。根据ICOS标准对CTRCD进行分类。基线风险按欧洲心脏病学会（ESC）风险分类分层。结果75例患者中有33例（44. %）发生sctrcd，其中轻度17 %，中度23 %，重度4 %。基线年龄、性别、BMI和大多数心血管危险因素与CTRCD无显著相关性。冠状动脉疾病是唯一与CTRCD升高相关的基线变量（OR 11.0, p = 0.029；单变量分析），而基线时hs-cTnT、NT-proBNP升高或LVEF降低没有预测作用。绝对CTRCD数在esc定义的心血管高危组最高，而发生率在低危组最高。其他心脏并发症41例（55% %）。结论sctrcd在BRAF/MEK抑制剂治疗的患者中较为常见。传统的心血管危险因素不能预测，尽管冠状动脉疾病成为一个强有力的危险标志。这些发现突出了动态监测战略的必要性。

{"title":"Cardiotoxic effects of BRAF/MEK inhibition: An observational study","authors":"Jannek Brauer , Daniel Scheidet , Sebastian Romann , Christina Zehender , Jessica Hassel , Norbert Frey , Lorenz H. Lehmann","doi":"10.1016/j.ejca.2025.116182","DOIUrl":"10.1016/j.ejca.2025.116182","url":null,"abstract":"<div><h3>Background</h3><div>BRAF/MEK inhibitors are a cornerstone of the therapy of BRAF-mutant cancers. Despite frequent use, the incidence of cardiovascular side effects is still unclear. Data on cancer therapy-related cardiac dysfunction (CTRCD), particularly using contemporary biomarker-inclusive definitions, remain limited.</div></div><div><h3>Objectives</h3><div>To assess the incidence and risk factors of CTRCD in patients receiving BRAF/MEK inhibitors, using the International Cardio-Oncology Society (ICOS) definitions, which include cardiac imaging and biomarker assessments.</div></div><div><h3>Methods</h3><div>A total of 75 patients treated with BRAF/MEK inhibitors underwent prospective cardiotoxicity monitoring with two follow-up visits at 90 days (IQR 36–137 days) and 199 days (IQR 115–266 days). Standardized evaluations included echocardiography with global longitudinal strain (GLS), high-sensitivity cardiac troponin T (hs-cTnT), and NT-proBNP measurements at baseline and follow-up visits. CTRCD was classified according to ICOS criteria. Baseline risk was stratified by European Society of Cardiology (ESC) risk categories.</div></div><div><h3>Results</h3><div>CTRCD occurred in 33 of 75 patients (44 %), with 17 % classified as mild, 23 % moderate, and 4 % severe. Baseline age, sex, BMI, and most cardiovascular risk factors were not significantly associated with CTRCD. Coronary artery disease was the only baseline variable associated with increased CTRCD (OR 11.0, p = 0.029; univariate analysis), whereas elevated hs-cTnT, NT-proBNP, or reduced LVEF at baseline were not predictive. Absolute CTRCD numbers were highest in the high ESC-defined cardiovascular risk category group, while incidence peaked in the low-risk group. Other cardiac complications occurred in 41 patients (55 %).</div></div><div><h3>Conclusions</h3><div>CTRCD is frequent among patients treated with BRAF/MEK inhibitors. Traditional cardiovascular risk factors were not predictive, although coronary artery disease emerged as a strong risk marker. These findings highlight the need for dynamic surveillance strategies.</div></div>","PeriodicalId":11980,"journal":{"name":"European Journal of Cancer","volume":"233 ","pages":"Article 116182"},"PeriodicalIF":7.1,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145788030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Review and comment on the retrospective analyses of the effect of immunotherapy-infusion time of day on outcome in patients with advanced non-small cell lung cancer 回顾和评论免疫治疗输注时间对晚期非小细胞肺癌患者预后影响的回顾性分析。

IF 7.1 1区医学 Q1 ONCOLOGY

European Journal of Cancer

Pub Date : 2025-12-11 DOI: 10.1016/j.ejca.2025.116171

Van Tai Nguyen , Rufina Binoy, Foteini Kalofonou, Michael Davidson, Mary O’Brien

引用次数: 0

Enhancing clinicians’ trust in large language models via transparent source attribution: A randomized controlled evaluation in uro-oncology 通过透明来源归因增强临床医生对大型语言模型的信任：一项泌尿肿瘤学随机对照评估。

IF 7.1 1区医学 Q1 ONCOLOGY

European Journal of Cancer

Pub Date : 2025-12-11 DOI: 10.1016/j.ejca.2025.116168

Nicolas Carl , Martin Joachim Hetz , Christoph Wies , Sarah Haggenmüller , Jana Theres Winterstein , Maurin Helen Mangold , Lasse Maywald , Thomas Stefan Worst , Niklas Westhoff , Maurice Stephan Michel , Frederik Wessels , Titus Josef Brinker

Introduction

Large language models (LLMs) are utilized to answer queries in urology and oncology, yet the performance is limited due to outdated data and missing source transparency, which undermines clinical reliability and therefore adoption.

Material and methods

We developed UroBot, a urology-specific chatbot integrating retrieval-augmented generation (RAG) to provide in-line references and source text previews for each response. In a randomized controlled reader study, UroBot and ChatGPT were compared across ten uro-oncological case rounds. Thirty urologists assessed recommendation correctness, source verifiability and trust with preference ratings collected after each round.

Results

UroBot performed significantly better than ChatGPT in recommendation correctness (73 % vs. 50 %; p < 0.001), source attribution (74 % vs. 30 %; p < 0.001) and verifiability of sources (84 % vs. 35 %; p < 0.001). Furthermore, clinicians consistently preferred UroBot for accuracy, source verifiability and trust. Qualitative analysis showed that ChatGPT often produced vague or incorrect citations, with 28 % being non-existent or outdated and 83 % lacking specific sections, whereas UroBot achieved complete alignment on guideline sub-section and page level. These gains in citation precision were mirrored by higher clinician ratings for verifiability and trust. Limitations include the small sample size of ten cases due to feasibility, which may not cover the full uro-oncological spectrum.

Conclusion

Our findings show that combining LLMs with RAG with in-line references and source text previews markedly enhances perceived source attribution and verifiability compared to state-of-the-art conventional LLMs. Importantly, this approach is readily transferable across medical subspecialties, enabling reliable and up-to-date clinical decision support.

简介：大型语言模型（llm）用于回答泌尿外科和肿瘤学的查询，但由于过时的数据和缺乏来源透明度，性能受到限制，这破坏了临床可靠性，因此被采用。材料和方法：我们开发了UroBot，一个泌尿科专用的聊天机器人，集成了检索增强生成（RAG），为每个回复提供内联参考和源文本预览。在一项随机对照阅读器研究中，UroBot和ChatGPT在10个泌尿肿瘤病例轮次中进行了比较。30名泌尿科医生评估推荐的正确性、来源的可验证性和信任度，并在每一轮后收集偏好评分。结果：UroBot在推荐正确性方面的表现明显优于ChatGPT（73% % vs. 50% %;p ）结论：我们的研究结果表明，与最先进的传统llm相比，将llm与带有内联参考文献和源文本预览的RAG相结合，显著提高了感知源归因和可验证性。重要的是，这种方法很容易在医学亚专科之间转移，从而实现可靠和最新的临床决策支持。

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引用次数: 0

Corrigendum to “International expert consensus on the clinical integration of circulating tumor cells in solid tumors” [Eur. J. Cancer 231 (2025) 116050] “循环肿瘤细胞在实体瘤中的临床整合的国际专家共识”的勘误表[欧洲]。癌症[j] . 231 (2025) 116050]

IF 7.1 1区医学 Q1 ONCOLOGY

European Journal of Cancer

Pub Date : 2025-12-10 DOI: 10.1016/j.ejca.2025.116167

Eleonora Nicolò , Carolina Reduzzi , Jean-Yves Pierga , Paola Gazzaniga , Nikolas H. Stoecklein , Valeria Denninghoff , Dominic G. Rothwell , Johann S. De Bono , Dario Marchetti , Evi Lianidou , Sabine Riethdorf , Daniele Generali , Paul Hofman , Lorenzo Gerratana , Peter Kuhn , Jean Paul Thiery , Michail Ignatiadis , Francois-Clement Bidard , Anthony Lucci , Sabine Kasimir-Bauer , Massimo Cristofanilli

引用次数: 0

Long-term outcomes of preoperative nivolumab with or without relatlimab in patients with resectable non-small-cell lung cancer (NEOpredict-Lung) 可切除的非小细胞肺癌患者术前nivolumab联合或不联合relalmab的长期预后（nepredict - lung）

IF 7.1 1区医学 Q1 ONCOLOGY

European Journal of Cancer

Pub Date : 2025-12-05 DOI: 10.1016/j.ejca.2025.116165

Kristof Cuppens , Marcel Wiesweg , Paul Baas , Brigitte Maes , Bert Du Pont , Till Ploenes , Dirk Theegarten , Michel Vanbockrijck , Clemens Aigner , Koen Hartemink , Fabian Doerr , Servet Bölükbas , Karin Pat , Martin Schuler

Background

Preoperative immunotherapy targeting PD-1/-L1 with chemotherapy induces histopathological responses and improves survival in patients with resectable non-small cell lung cancer (NSCLC). NEOpredict-Lung (NCT04205552) established the feasibility of dual blockade of PD-1 and LAG-3 immune checkpoints prior to curatively intended resection. Here we report extended follow-up, postoperative treatments and patterns of response and recurrence.

Patients and methods

Patients with resectable NSCLC (stages IB-IIIA) were randomized to receive two doses nivolumab (240 mg, arm A) with or without relatlimab (80 mg, arm B) every 2 weeks. Overall and disease-free survival (OS, DFS) rates, response and recurrence patterns and subsequent therapies were evaluated.

Results

60 patients were enrolled from March 2020 to July 2022. The present analysis was conducted per December 2024 with a median follow-up of 37.4 months. 45 patients were alive without disease recurrence,15 patients recurred (4 locoregional and 11 metastatic), and 7 patients died. The 3-year OS and DFS rates were 88.4 % and 73.3 % in arm A and 88.9 % and 60.3 % in arm B. Patients achieving major pathological response (≤10 % viable tumor cells in resected NSCLC) trended towards better DFS (HR 0.35; 95 % CI, 0.1–1.19). Downstaging was confirmed in 53.3 % of patients in arm A and in 66.7 % of patients in arm B. Nodal downstaging occurred in 28.6 % of patients with nodal disease in arm A and in 66.7 % of patients in arm B.

Conclusions

Short course preoperative nivolumab with or without relatlimab showed encouraging efficacy and survival outcomes, which compare favorably with chemo-immunotherapy-based perioperative treatment regimens.

背景：术前针对PD-1/-L1的免疫治疗联合化疗可诱导可切除的非小细胞肺癌（NSCLC）患者的组织病理反应并提高生存率。nepredict - lung （NCT04205552）确定了在治疗预期切除前双重阻断PD-1和LAG-3免疫检查点的可行性。在这里，我们报告延长随访，术后治疗和模式的反应和复发。患者和方法可切除的NSCLC （IB-IIIA期）患者每2周随机接受两种剂量的nivolumab（240 mg， A组）联合或不联合relatlimab（80 mg， B组）。评估总生存率和无病生存率（OS， DFS）、反应和复发模式以及随后的治疗。结果从2020年3月至2022年7月入组60例患者。本分析于2024年12月进行，中位随访时间为37.4个月。45例患者存活，无疾病复发，15例复发（4例局部，11例转移），7例死亡。A组的3年OS和DFS率分别为88.4 %和73.3 %，b组的3年OS和DFS率分别为88.9 %和60.3 %。达到主要病理反应（切除的NSCLC中活肿瘤细胞≤10 %）的患者趋向于更好的DFS （HR 0.35; 95 % CI, 0.1-1.19）。A组53.3 %的患者和b组66.7 %的患者证实了分期降低，A组28.6 %的淋巴结疾病患者和b组66.7 %的患者证实了分期降低。结论短期术前尼武单抗联合或不联合相对单抗显示出令人鼓舞的疗效和生存结果，与基于化学免疫治疗的围手术期治疗方案相比优势明显。

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引用次数: 0