Department of Medical Oncology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China; Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China.
Department of Thoracic Oncology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, China.
Eur J Cancer. 2022 Oct;174:21-30. doi: 10.1016/j.ejca.2022.06.059. Epub 2022 Aug 12.
Immunotherapy has demonstrated good efficacy and survival outcomes in solid tumours. However, efficacy data for immune checkpoint inhibitors (ICIs) in advanced thymic carcinoma are lacking. The present study aimed to assess the activity of ICIs in advanced thymic carcinoma.
A multicentre retrospective study was conducted to explore the efficacy and safety of ICIs for advanced thymic carcinoma. Objective response rate (ORR), progression-free survival (PFS), overall survival, and immune-related adverse events (irAEs) were analysed. In addition, factors independently associated with treatment efficacy and survival outcomes were evaluated.
A total of 77 patients with advanced thymic carcinoma were enrolled between March 2016 and September 2021. The ORR was existing the difference between ICIs monotherapy (n = 23) and ICIs combined with chemotherapy (n = 54) (17.4% versus 44.4%, P = 0.024). The ICIs combination treatments were associated with better median PFS (mPFS) compared to ICIs monotherapy (12.7 months versus 2.1 months, P < 0.001). Notably, liver or brain metastasis was a poor prognostic factor of mPFS (1.8 months versus 3.5 months, P = 0.012) in the ICIs monotherapy group. In addition, mPFS for the first-line treatment (n = 27) was longer than that for ICIs as the second- or posterior-line treatment (n = 50) (P < 0.001). The incidence of irAEs was 54.5% (42/77) in the 77 enrolled patients. The incidence of grade 3-4 irAE was 15.6% (12/77).
Immunotherapy is effective in advanced thymic carcinoma, especially for combination with chemotherapy showed promising antitumour activity, which indicates worthy of combination treatment strategy for further study. IrAEs also require close monitoring and management.
免疫疗法已在实体瘤中显示出良好的疗效和生存结果。然而，免疫检查点抑制剂（ICI）在晚期胸腺癌中的疗效数据尚缺乏。本研究旨在评估 ICI 在晚期胸腺癌中的活性。
进行了一项多中心回顾性研究，以探讨 ICI 治疗晚期胸腺癌的疗效和安全性。分析了客观缓解率（ORR）、无进展生存期（PFS）、总生存期和免疫相关不良事件（irAE）。此外，还评估了与治疗疗效和生存结果相关的独立因素。
共纳入 2016 年 3 月至 2021 年 9 月间的 77 例晚期胸腺癌患者。ICI 单药治疗（n=23）与 ICI 联合化疗（n=54）的 ORR 存在差异（17.4% vs. 44.4%，P=0.024）。ICI 联合治疗与 ICI 单药治疗相比，中位 PFS（mPFS）更长（12.7 个月 vs. 2.1 个月，P<0.001）。值得注意的是，肝或脑转移是 ICI 单药治疗组 mPFS 的不良预后因素（1.8 个月 vs. 3.5 个月，P=0.012）。此外，一线治疗（n=27）的 mPFS 长于二线或后续治疗（n=50）（P<0.001）。77 例入组患者的 irAE 发生率为 54.5%（42/77）。3-4 级 irAE 的发生率为 15.6%（12/77）。
免疫疗法在晚期胸腺癌中有效，特别是联合化疗显示出有前景的抗肿瘤活性，这表明值得进一步研究联合治疗策略。irAE 也需要密切监测和管理。
