Gupta Vineet Govinda, Rangaraju Ranga Rao, Abbas Waseem, Bajpai Peush, Khetrapal Ruchika
Department of Medical Oncology, Max Super Speciality Hospital, New Delhi, India.
South Asian J Cancer. 2019 Jan-Mar;8(1):65-68. doi: 10.4103/sajc.sajc_167_18.
The immune checkpoint inhibitors (ICIs) nivolumab and pembrolizumab have shown dramatic efficacy with low toxicity in international studies of advanced solid cancers. No published Indian experience with ICIs exist other than isolated case reports.
The aim of this study is to evaluate real-world data about the efficacy and toxicity of ICIs in advanced solid cancers among Indian patients who have progressed on one or more prior lines of chemotherapy.
All patients with advanced solid cancers who received ICIs after the failure of chemotherapy at our center were retrospectively assessed. Information about efficacy and toxicity was collected and analyzed.
The present study included 24 patients who had received ICIs for indications including non-small cell lung, bladder, head and neck, gastrointestinal, and unknown primary cancer. Patients had received a median of two prior lines of chemotherapy (range 1-5). Grade III or higher toxicity was seen in 8% of patients. Clinical benefit at 3 months was realized in 33% of evaluable patients. Twenty-six percentages of evaluable patients achieved a response, including one patient who achieved a complete response that is ongoing at 18 months. Median progression-free survival was 3 months, and median overall survival was 8 months at a median follow-up of 10 months. Among patients who achieved clinical benefit, the majority (84%) have an ongoing response at the time of data cutoff.
Efficacy and toxicity of ICIs in the Indian population are similar to the experience seen in large international cohorts, and Indian oncologists may feel reassured using these agents in similar settings.
在晚期实体癌的国际研究中,免疫检查点抑制剂纳武单抗和派姆单抗已显示出显著疗效且毒性较低。除了个别病例报告外,印度尚无关于免疫检查点抑制剂的已发表经验。
本研究的目的是评估在接受过一线或多线化疗后病情进展的印度患者中,免疫检查点抑制剂治疗晚期实体癌的疗效和毒性的真实世界数据。
对在我们中心化疗失败后接受免疫检查点抑制剂治疗的所有晚期实体癌患者进行回顾性评估。收集并分析有关疗效和毒性的信息。
本研究纳入了24例接受免疫检查点抑制剂治疗的患者,其适应症包括非小细胞肺癌、膀胱癌、头颈癌、胃肠道癌和原发灶不明的癌症。患者接受的化疗中位数为两线(范围1-5线)。8%的患者出现3级或更高等级的毒性。33%的可评估患者在3个月时实现了临床获益。26%的可评估患者获得了缓解,包括1例在18个月时仍持续完全缓解的患者。中位无进展生存期为3个月,在中位随访10个月时,中位总生存期为8个月。在实现临床获益的患者中,大多数(84%)在数据截止时仍有持续缓解。
免疫检查点抑制剂在印度人群中的疗效和毒性与大型国际队列中的经验相似,印度肿瘤学家在类似情况下使用这些药物可能会感到放心。