肾癌转移对靶向和免疫治疗反应的标准

V. Blinov, A. S. Blinova, V. Petkau, S. Demidov
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引用次数: 1

摘要

目的:比较转移性肾癌靶向治疗与免疫治疗的肿瘤反应标准。研究对象和方法。本文报告20例转移性肾细胞癌的诊断和治疗结果。其中10例患者采用干扰素- α作为免疫治疗,10例患者采用索拉非尼作为靶向治疗。根据RECIST 1.1、Choi、mChoi和SACT标准,使用计算机断层扫描评估靶向病灶的反应。对照ct每3个月进行一次,直到疾病进展。采用Kaplan-Meier法计算无进度时间。结果。调查显示,在所有评估病例的进展方面,符合RECIST 1.1、Choi、mChoi和SACT标准;50%的病例符合部分反应标准,8.7%的病例符合稳定性标准。其他案例对结果的解释存在差异。根据RECIST 1.1标准、Choi和mChoi标准以及SACT标准接受免疫治疗的患者无进展时间分别为6.3±0.7个月、4.3±0.6个月和4.5±0.7个月。根据上述标准接受靶向治疗的患者无进展时间分别为10.3±1.2个月、6.4±1.2个月和6.7±1.3个月。结论。肿瘤对治疗的反应是评估抗癌治疗效果的关键。靶向和免疫药物不仅引起肿瘤大小的改变,而且引起坏死和囊性变性。该标准不仅基于肿瘤大小的变化,而且还基于肿瘤病灶密度的变化,具有较短的无进展时间,并且可以在较早的日期识别疾病进展的患者。
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Criteria for Responses of Renal Cancer Metastases to Targeted and Immunotherapy
Objective: to compare the criteria for tumor response to targeted therapy and immunotherapy for metastatic kidney cancer. Subjects and methods. The paper presents the results of diagnosis and treatment in 20 patients with metastatic renal cell carcinoma. Of these, 10 patients took interferon- α as immunotherapy, 10 patients received sorafenib as targeted therapy. The response of targeted foci was assessed using computed tomography according to the RECIST 1.1, Choi, mChoi, and SACT criteria. Control CTs were performed every 3 months until the disease progressed. The progression-free time was calculated using the Kaplan-Meier method. Results. The investigation revealed the coincidence according to the RECIST 1.1, Choi, mChoi and SACT criteria in terms of progression in all assessed cases; that according to the partial response criterion in 50% of cases, and that according to the stability criterion in 8.7%. Other cases displayed a discrepancy in the interpretation of the results. The progression-free time for patients receiving immunotherapy according to the RECIST 1.1 criteria, the Choi and mChoi criteria, and the SACT criteria was 6.3 ± 0.7, 4.3 ± 0.6, and 4.5 ± 0.7 months, respectively. The progression-free time for patients receiving targeted therapy according to the above criteria was 10.3 ± 1.2, 6.4 ± 1.2, and 6.7 ± 1.3 months. Conclusion. Tumor response to therapy is critical in evaluating the efficiency of anticancer treatment. Targeted and immunological drugs cause not only a tumor size change, but also necrosis and cystic degeneration. The criteria based not only on changes in size, but also on those in the density of tumor foci have a shorter progression-free time and make it possible to identify patients with disease progression at an earlier date.
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