Clin Cancer Res:纳武单抗加用多西他赛可显著延长ICI初治NSCLC患者的生存期

2022-09-06 MedSci原创 MedSci原创

虽然毒性略有升高,但在纳武单抗中加用多西他赛显著延长了先前接受过治疗的 ICI 初治 NSCLC 患者的总生存期和无进展生存期。

免疫检查点抑制剂 (ICI) 中加入细胞毒性化学疗法可增强抗肿瘤作用。Yuri Taniguchi等研究人员进行了一项开放标签的随机 II/III 期研究,以评估纳武单抗+多西他赛联合治疗相比纳武单抗单药治疗在既往治疗过的 ICI 初治的非小细胞肺癌 (NSCLC) 中的疗效。

该研究招募了组织学或病理学明确诊断的IIIB/IIIC/IV期或术后复发的既往接受过一线或二线化疗的NSCLC患者,随机分至两组。主要终点是总生存期(OS),次要终点包括无进展生存期(PFS)、总生存率(ORR)和毒性。


两组的OS和PFS

共招募了128位患者(每组各64位),被纳入总分析人群。纳武单抗组和纳武单抗+多西他赛组的中位OS分别是14.7个月(95%CI 11.4-18.7)和23.1个月(16.7-未达到[NR];HR 0.63, 90%CI 0.42-0.95,p=0.0310)。纳武单抗组和纳武单抗+多西他赛组的中位PFS分别是3.1个月(95%CI 2.0-3.9)和6.7个月(3.8-9.4;HR 0.58, 95%CI 0.39-0.88,p=0.0095)。纳武单抗组和纳武单抗+多西他赛组的客观缓解率分别是14.0%和41.8%。


不良反应发生情况

纳武单抗与多西他赛联合使用时的血液毒性和消化道不良反应比单用纳武单抗时更常见。两组各发生了一例治疗相关死亡,纳武单抗组一例死于肺炎,纳武单抗+多西他赛组一例死于心肌炎。

总之,虽然毒性略有升高,但在纳武单抗中加用多西他赛显著延长了先前接受过治疗的 ICI 初治 NSCLC 患者的总生存期和无进展生存期。

原始出处:

Yuri Taniguchi, Tsuneo Shimokawa, Yuichi Takiguchi, et al. A Randomized Comparison of Nivolumab versus Nivolumab + Docetaxel for Previously Treated Advanced or Recurrent ICI-Na?ve Non–Small Cell Lung Cancer: TORG1630. Clin Cancer Res 2022; https://doi.org/10.1158/1078-0432.CCR-22-1687

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