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食管原发性恶性黑色素瘤:76 例患者的临床特征、治疗和生存的回顾性分析。

Primary malignant melanoma of the esophagus: A retrospective analysis of clinical features, management, and survival of 76 patients.

机构信息

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Renal Cancer and Melanoma, Peking University Cancer Hospital and Research Institute, Beijing, China.

出版信息

Thorac Cancer. 2019 Apr;10(4):950-956. doi: 10.1111/1759-7714.13034. Epub 2019 Mar 12.

Abstract

BACKGROUND

Primary malignant melanoma of the esophagus (PMME) is rare. Patients with advanced melanoma of esophageal origin tend to have lower response rates to traditional therapies than those with other melanomas. We report our experience of 12 patients with PMME administered PD-1 inhibitors.

METHODS

This is a retrospective analysis of the clinical data of 76 patients with PMME who attended Peking University Cancer Hospital between January 2008 and September 2017. Objective response rates (ORRs) and progression-free survival (PFS) were assessed.

RESULTS

The 76 PMMEs were classified as unresectable or metastatic. The patients were allocated to three cohorts according to their treatment: chemotherapy (C: 46 patients), targeted therapy (T: 2 patients), and PD-1 inhibitors (IT: 12 patients). The PFS in the C cohort was three months with a limited ORR of 10.9%. In the IT cohort, seven patients (75.0%) achieved a partial response and three had stable disease for 4+ months. The median PFS in the IT cohort was not reached and the mean was 15.6 months, which was much longer than in cohort C (P < 0.001).

CONCLUSION

Although this cohort of patients was small, it is the largest series investigated thus far. To the best of our knowledge, this is the first report of the outcomes of advanced PMMEs treated with PD-1 inhibitors. Dramatic responses can occur in patients with advanced PMMEs.

摘要

背景

原发性食管恶性黑色素瘤(PMME)较为罕见。与其他黑色素瘤相比,食管起源的晚期黑色素瘤患者对传统疗法的反应率较低。我们报告了 12 例接受 PD-1 抑制剂治疗的 PMME 患者的经验。

方法

这是对 2008 年 1 月至 2017 年 9 月期间在北京大学肿瘤医院就诊的 76 例 PMME 患者的临床资料进行的回顾性分析。评估了客观缓解率(ORR)和无进展生存期(PFS)。

结果

76 例 PMME 被归类为不可切除或转移性。根据治疗方法将患者分为三组:化疗(C:46 例)、靶向治疗(T:2 例)和 PD-1 抑制剂(IT:12 例)。C 组的 PFS 为 3 个月,ORR 有限为 10.9%。在 IT 组中,7 名患者(75.0%)达到部分缓解,3 名患者的疾病稳定期为 4 个月以上。IT 组的中位 PFS 未达到,平均为 15.6 个月,明显长于 C 组(P<0.001)。

结论

尽管该患者队列较小,但这是迄今为止研究最多的系列。据我们所知,这是首次报告使用 PD-1 抑制剂治疗晚期 PMME 的结果。晚期 PMME 患者可能会出现显著的反应。

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