非小细胞肺癌:纳布-紫杉醇--免疫检查点疗法失败后的有效选择

Susanne Otto, W. Schütte
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引用次数: 0

摘要

导言:最近的研究表明,免疫检查点抑制剂(ICI)治疗后的后续化疗可增强治疗效果,这凸显了后续治疗选择的重要性。白蛋白结合型纳米粒子紫杉醇(nab-PTX)常用于后续化疗,但其作为ICI治疗后的后续治疗的疗效尚未见报道。方法我们利用之前报告的两项前瞻性研究对 nab-PTX 的疗效和安全性进行了回顾性评估。第一项研究评估了 nab-PTX 作为一线细胞毒性化疗(不包括 ICI)失败后二线治疗的疗效和安全性(研究 1;n = 32),另一项研究评估了 nab-PTX 作为 ICI 治疗失败后的后续治疗的疗效和安全性(研究 2;n = 29)。研究结果研究 2 的客观反应率{55.2%(95% 置信区间[CI]:28.1-79.6)}明显高于研究 1(28.1% [95% CI:13.7-46.7])(p = 0.04)。虽然研究 2 的疾病控制率(86.2% [95%CI:65.9-97.0])略高于研究 1(71.9% [95%CI:53.3-86.3]),但没有显著差异(P = 0.2)。研究 2 的中位无进展生存期明显长于研究 1(研究 1 为 3.9 个月 [95% CI:2.0-5.5] vs. 研究 2 为 5.6 个月 [95% CI:3.0-12.8];危险比 [HR]:0.46 [95% CI: 0.27-0.81], p = 0.006)。尽管接受 nab-PTX 晚期治疗的患者人数较多,但研究 2 的中位总生存期略长,但研究 1 和研究 2 之间没有显著差异(研究 1 为 10.9 个月 [95% CI:5.1-16.8],研究 2 为 11.9 个月 [95% CI:7.6-24.8];HR:0.77 [95% CI:0.46-1.31],p = 0.34)。研究 1 和研究 2 的患者在安全性方面没有差异。
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NSCLC: nab-Paclitaxel – eine effektive Option nach Versagen einer Immuncheckpoint-Therapie
Introduction: Recent studies have suggested enhanced therapeutic effects of subsequent chemotherapy after immune checkpoint inhibitor (ICI) treatment, highlighting the importance of subsequent treatment selection. Nanoparticle albumin-bound paclitaxel (nab-PTX) is commonly used in subsequent chemotherapies; however, its efficacy as a subsequent treatment after ICI treatment has not been reported. Methods: We retrospectively evaluated the efficacy and safety of nab-PTX using two prospective studies that we previously reported. The first study evaluated the efficacy and safety of nab-PTX as a second-line treatment after the failure of the first-line cytotoxic chemotherapy, excluding ICI (study 1; n = 32), and the other as a subsequent treatment after failure of ICI treatment, regardless of treatment line (study 2; n = 29). Results: The objective response rate was significantly higher in study 2 {55.2% (95% confidence interval [CI]: 28.1–79.6)} than in study 1 (28.1% [95% CI: 13.7–46.7]) (p = 0.04). Although the disease control rate was slightly higher in study 2 (86.2% [95%CI: 65.9–97.0]) than in study 1 (71.9% [95% CI: 53.3–86.3]), there was no significant difference (p = 0.2). The median progression-free survival was significantly longer in study 2 than in study 1 (3.9 months [95% CI: 2.0–5.5] in study 1 vs. 5.6 months [95% CI: 3.0–12.8] in study 2; hazard ratio [HR]: 0.46 [95% CI: 0.27–0.81], p = 0.006). The median overall survival was slightly longer in study 2 despite the greater number of patients who received nab-PTX in late treatment line, but there was no significant difference between study 1 and study 2 (10.9 months [95% CI: 5.1–16.8] in study 1 vs.11.9 months [95% CI: 7.6–24.8] in study 2; HR: 0.77 [95% CI: 0.46–1.31], p = 0.34). Safety profiles did not differ between the patients in studies 1 and 2.
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