晚期非小细胞肺癌患者免疫检查点抑制剂再激发治疗
Immune checkpoint inhibitor re-challenge in patients with advanced non-small cell lung cancer.
作者信息
Niki Maiko, Nakaya Aya, Kurata Takayasu, Yoshioka Hiroshige, Kaneda Toshihiko, Kibata Kayoko, Ogata Makoto, Nomura Shosaku
机构信息
First Department of Internal Medicine, Kansai Medical University, Shin-machi, Hirakata, Osaka 573-1010, Japan.
出版信息
Oncotarget. 2018 Aug 17;9(64):32298-32304. doi: 10.18632/oncotarget.25949.
BACKGROUND
Immune checkpoint inhibitors have dramatically changed lung cancer treatment, demonstrating an overall survival benefit. There are limited data about re-challenge in patients with non-small cell lung cancer. We attempted to address this question for re-challenge of immune checkpoint inhibitor in patients with advanced non-small cell lung cancer.
METHODS
We retrospectively analyzed 11 patients with advanced non-small cell lung cancer treated with nivolumab and re-challenged with nivolumab/pemblorizumab at Kansai Medical University Hospital from December 2015 to December 2017.
RESULTS
Three patients achieved PR and two patients were in SD. These patients were apt to be good responders to the initial treatment, to develop immune-related adverse events and to be immediately started on re-challenge with immune checkpoint inhibitor. The median PFS was 2.7 (range, 0.5-16.1) months. Five patients (45%) had mild to moderate immune-related adverse events.
CONCLUSION
Our study shows the effectiveness of re-challenge of immune checkpoint inhibitors in a subset of non-small cell lung cancer patients. Re-challenge might become one of treatment option for advanced non-small cell lung cancer.
背景
免疫检查点抑制剂显著改变了肺癌治疗方式，显示出总体生存获益。关于非小细胞肺癌患者再次使用免疫检查点抑制剂的数据有限。我们试图解决晚期非小细胞肺癌患者再次使用免疫检查点抑制剂这一问题。
方法
我们回顾性分析了2015年12月至2017年12月在关西医科大学医院接受纳武单抗治疗并再次接受纳武单抗/派姆单抗治疗的11例晚期非小细胞肺癌患者。
结果
3例患者达到部分缓解（PR），2例患者病情稳定（SD）。这些患者倾向于是初始治疗的良好反应者，易于发生免疫相关不良事件，并能立即开始再次使用免疫检查点抑制剂治疗。中位无进展生存期（PFS）为2.7（范围0.5 - 16.1）个月。5例患者（45%）发生了轻度至中度免疫相关不良事件。
结论
我们的研究显示了免疫检查点抑制剂再次治疗在一部分非小细胞肺癌患者中的有效性。再次治疗可能成为晚期非小细胞肺癌的治疗选择之一。
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