Medical Oncology Unit 1, Ospedale Policlinico San Martino IST, University of Genova, Largo R. Benzi 10, 16143, Genova, Italy.
Emergency Radiology, Ospedale Policlinico San Martino IST, University of Genova, Largo R. Benzi 10, 16143, Genova, Italy.
Immunotherapy. 2018 Sep;10(13):1123-1132. doi: 10.2217/imt-2018-0042.
Immunotherapy is associated with different response patterns compared with chemotherapy and targeted therapy, including delayed response and stabilization after progression (pseudoprogression). According to new immuno-based response criteria, immunotherapy can be continued after radiological progression when a clinical benefit is observed. We report a case of an advanced renal cell carcinoma patient treated with nivolumab, who developed clinical benefit and delayed radiological response after initial progression. We performed a review of the literature on immunotherapy beyond progression in advanced solid tumors. 12 clinical trials were identified and showed that selected patients have subsequent response and survival benefit receiving immunotherapy beyond progression. Future studies are needed to optimize timing and duration of immunotherapy and to define patient selection criteria for treatment beyond progression.
与化疗和靶向治疗相比,免疫疗法具有不同的反应模式,包括进展后的延迟反应和稳定(假性进展)。根据新的免疫反应标准,当观察到临床获益时,即使影像学进展后也可以继续进行免疫治疗。我们报告了一例接受nivolumab 治疗的晚期肾细胞癌患者的病例,该患者在初始进展后出现了临床获益和延迟的影像学反应。我们对晚期实体瘤中免疫治疗进展后的研究进行了文献回顾。共确定了 12 项临床试验,结果表明,选择合适的患者进行免疫治疗进展后治疗可获得后续反应和生存获益。未来需要进行更多的研究来优化免疫治疗的时机和持续时间,并确定治疗进展后的患者选择标准。