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真实世界中使用西妥昔单抗治疗皮肤鳞状细胞癌的安全性结局。

Real world safety outcomes using cemiplimab for cutaneous squamous cell carcinoma.

机构信息

Dermatology Department, CHU Bordeaux, F-33000 Bordeaux, France.

Pôle de Santé Publique, Unité de Soutien Méthodologique à la Recherche Clinique et Epidémiologique, CHU de Bordeaux, Bordeaux, France.

出版信息

J Geriatr Oncol. 2021 Sep;12(7):1110-1113. doi: 10.1016/j.jgo.2021.02.026. Epub 2021 Mar 15.

Abstract

INTRODUCTION

Locally advanced or metastatic cutaneous squamous cell carcinoma (cSCC) mostly affects older and frail patients. Cemiplimab is an anti-PD1 antibody used in this indication since its approval by the FDA and the EMA in 2019 after encouraging results from phase II trials. We aimed to evaluate cemiplimab safety in patients from daily practice.

METHODS

Retrospective and monocentric study including all patients who received at least one infusion of cemiplimab between August 2018 and September 2019. Adverse effects (AEs), treatment interruption, and efficacy were recorded (data cut-off, November 1st 2020).

RESULTS

Twenty-two patients were included, median age was 83 [55-93], 73% were Eastern Cooperative Oncology Group (ECOG) 0 or 1, 36% were immune compromised. After a median time on treatment of six months [0.7-22], seventeen patients (77%) experienced 24 AEs, comprising 45% serious AEs (SAEs) grade ≥ 3 and one SAE grade 5 (myositis). Patients who presented SAEs were all >65 years old. Nine patients (41%) definitively discontinued treatment due to AEs. Seventeen patients were evaluable, after a median follow-up of eleven months [1-22], 32% had an objective response (2 complete and 5 partial responses), 47% had controlled disease and 35% experienced progression.

CONCLUSIONS

In our cohort, safety seemed to be worse than in phase II trial with more treatment discontinuations due to cemiplimab toxicity, probably reflecting the distinct demographic and medical characteristics of patients in daily care.

摘要

简介

局部晚期或转移性皮肤鳞状细胞癌(cSCC)主要影响老年和体弱患者。Cemiplimab 是一种抗 PD-1 抗体,自 2019 年获得 FDA 和 EMA 的批准用于该适应症后,在 II 期临床试验中取得了令人鼓舞的结果。我们旨在评估 cemiplimab 在日常实践中的安全性。

方法

回顾性和单中心研究,包括 2018 年 8 月至 2019 年 9 月期间至少接受一次 cemiplimab 输注的所有患者。记录不良事件(AE)、治疗中断和疗效(数据截止日期为 2020 年 11 月 1 日)。

结果

共纳入 22 例患者,中位年龄为 83 岁[55-93],73%为东部肿瘤协作组(ECOG)0 或 1 级,36%免疫功能低下。中位治疗时间为 6 个月[0.7-22],17 例(77%)患者发生 24 例 AE,包括 45%的严重 AE(SAE)≥3 级和 1 例 SAE 5 级(肌炎)。发生 SAE 的患者均>65 岁。9 例(41%)患者因 AE 而永久停药。17 例患者可评估,中位随访 11 个月[1-22]后,32%有客观缓解(2 例完全缓解和 5 例部分缓解),47%疾病得到控制,35%疾病进展。

结论

在我们的队列中,安全性似乎比 II 期试验更差,由于 cemiplimab 毒性导致更多的治疗中断,这可能反映了日常护理中患者的不同人口统计学和医学特征。

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