免疫疗法在肺泡软组织肉瘤障碍中的组合比较影响及治疗学意义。

Comparative Combinatorial Implications and Theranostics of Immunotherapy in the Impediment of Alveolar Soft Part Sarcoma.

机构信息

Department of Radiation Therapy, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.

Department of Human Anatomy, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8/2 Trubetskaya str., Moscow, 119991, Russia.

出版信息

Curr Pharm Des. 2022;28(41):3404-3412. doi: 10.2174/1381612828666220921151750.

DOI:10.2174/1381612828666220921151750

PMID:36154597

Abstract

BACKGROUND

Immune checkpoint inhibitors (ICIs), specifically programmed cell death receptor- 1/ligand 1 (PD-1/L1) inhibitors, have shown potential pharmacological efficacy in several cancers. Nonetheless, data pertinent to their therapeutic efficacy in alveolar soft-part sarcoma (ASPS) are limited.

OBJECTIVE

The retrospective aspects of ICIs (anti-PD1/PD-L1 blockers) to target ASPS are comparatively analyzed for clinical outcomes with other targeted immunotherapy modalities.

METHODS

We have conducted a systematic review without statistical analysis or comprehensive meta-analysis by collecting the articles published between 1952 and Sep 10th, 2020, by searching the following words: alveolar soft part sarcoma and immunotherapy including immune checkpoint, immune checkpoint inhibitors, and PD-1, PD-L1. We performed a pooled analysis of case reports, conferences, clinical trials, and other research reports pertinent to the efficacy of a PD-1 or PD-L1 antagonist in patients diagnosed with metastatic ASPS.

RESULTS

The effective studies include 10 case reports, 2 conference reports, 5 clinical trials, and 2 additional research reports. A total of 110 patients were reported to be enrolled in the pooled analysis; among them, 87 (78.38%) received a PD-1/PD-L1 antagonist. For patients who received anti-PD-1/PD-L1as monotherapy, their clinical response rates (CRR) were 63.22% whereas those who received targeted therapy and immunotherapy had a CRR of 78.95% (15/19). In the patients treated with double immunotherapy, their CRR was 100% (4/4). Tumor mutational burden and mismatch repair status have significant implications for predicting the ASPS prognosis.

CONCLUSION

Alveolar soft-part sarcoma patients with distant metastases can exhibit better clinical outcomes with immunotherapy, particularly toripalimab, atezolizumab, and axitinib combinatorial regimen with pembrolizumab. In addition, this review describes the therapeutic implications to guide personalized medicine depending on the expression patterns of PD-1/PD-L1 during the immunotherapy with ASPS.

摘要

背景

免疫检查点抑制剂（ICI），特别是程序性死亡受体 1/配体 1（PD-1/L1）抑制剂，在多种癌症中显示出潜在的药理疗效。然而，关于它们在肺泡软组织肉瘤（ASPS）中的治疗效果的数据有限。

目的

比较分析免疫检查点抑制剂（抗 PD-1/PD-L1 阻滞剂）针对 ASPS 的临床疗效与其他靶向免疫治疗方法。

方法

我们通过检索 1952 年至 2020 年 9 月 10 日发表的文章，无统计学分析或综合荟萃分析，收集了文章，使用的关键词包括肺泡软组织肉瘤和免疫治疗，包括免疫检查点、免疫检查点抑制剂和 PD-1、PD-L1。我们对 PD-1 或 PD-L1 拮抗剂在诊断为转移性 ASPS 的患者中的疗效的病例报告、会议、临床试验和其他研究报告进行了汇总分析。

结果

有效研究包括 10 例病例报告、2 份会议报告、5 项临床试验和 2 份其他研究报告。共有 110 例患者被纳入汇总分析；其中 87 例（78.38%）接受了 PD-1/PD-L1 拮抗剂治疗。接受抗 PD-1/PD-L1 单药治疗的患者临床缓解率（CRR）为 63.22%，而接受靶向治疗和免疫治疗的患者 CRR 为 78.95%（15/19）。接受双重免疫治疗的患者 CRR 为 100%（4/4）。肿瘤突变负担和错配修复状态对预测 ASPS 预后具有重要意义。