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免疫检查点阻断治疗转移性葡萄膜黑色素瘤:耐药或毒性后的再诱导

Immune Checkpoint Blockade for Metastatic Uveal Melanoma: Re-Induction following Resistance or Toxicity.

作者信息

Koch Elias A T, Petzold Anne, Wessely Anja, Dippel Edgar, Gesierich Anja, Gutzmer Ralf, Hassel Jessica C, Haferkamp Sebastian, Kähler Katharina C, Knorr Harald, Kreuzberg Nicole, Leiter Ulrike, Loquai Carmen, Meier Friedegund, Meissner Markus, Mohr Peter, Pföhler Claudia, Rahimi Farnaz, Schadendorf Dirk, Schell Beatrice, Schlaak Max, Terheyden Patrick, Thoms Kai-Martin, Schuler-Thurner Beatrice, Ugurel Selma, Ulrich Jens, Utikal Jochen, Weichenthal Michael, Ziller Fabian, Berking Carola, Heppt Markus V

机构信息

Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany.

Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CCC ER-EMN), 91054 Erlangen, Germany.

出版信息

Cancers (Basel). 2022 Jan 20;14(3):518. doi: 10.3390/cancers14030518.

Abstract

Re-induction with immune checkpoint blockade (ICB) needs to be considered in many patients with uveal melanoma (UM) due to limited systemic treatment options. Here, we provide hitherto the first analysis of ICB re-induction in UM. A total of 177 patients with metastatic UM treated with ICB were included from German skin cancer centers and the German national skin cancer registry (ADOReg). To investigate the impact of ICB re-induction, two cohorts were compared: patients who received at least one ICB re-induction (cohort A, = 52) versus those who received only one treatment line of ICB (cohort B, = 125). In cohort A, a transient benefit of overall survival (OS) was observed at 6 and 12 months after the treatment start of ICB. There was no significant difference in OS between both groups ( = 0.1) with a median OS of 16.2 months (cohort A, 95% CI: 11.1-23.8) versus 9.4 months (cohort B, 95% CI: 6.1-14.9). Patients receiving re-induction of ICB (cohort A) had similar response rates compared to those receiving ICB once. Re-induction of ICB may yield a clinical benefit for a small subgroup of patients even after resistance or development of toxicities.

摘要

由于全身治疗选择有限,许多葡萄膜黑色素瘤(UM)患者需要考虑采用免疫检查点阻断(ICB)进行再诱导治疗。在此,我们提供了迄今为止对UM患者ICB再诱导的首次分析。从德国皮肤癌中心和德国国家皮肤癌登记处(ADOReg)纳入了177例接受ICB治疗的转移性UM患者。为了研究ICB再诱导的影响,比较了两个队列:接受至少一次ICB再诱导的患者(队列A,n = 52)与仅接受一个ICB治疗线的患者(队列B,n = 125)。在队列A中,在ICB治疗开始后的6个月和12个月观察到总生存期(OS)有短暂获益。两组之间的OS无显著差异(P = 0.1),中位OS为16.2个月(队列A,95%CI:11.1 - 23.8),而队列B为9.4个月(95%CI:6.1 - 14.9)。接受ICB再诱导(队列A)的患者与仅接受一次ICB的患者相比,缓解率相似。即使在出现耐药或毒性后,ICB再诱导可能对一小部分患者产生临床获益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/167e/8833453/bef8b0b378bb/cancers-14-00518-g001.jpg

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