The Comprehensive Cancer Center of Drum Tower Hospital, Medical School of Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, Jiangsu, China.
Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
Hum Vaccin Immunother. 2022 Nov 30;18(6):2143154. doi: 10.1080/21645515.2022.2143154. Epub 2022 Nov 22.
Previous clinical studies had not shown expected results in advanced pancreatic cancer (APC) with single-agent checkpoint inhibitors. Until the present day, little is known about their performance in real-world settings. So, in this study, we investigate the ICIs' efficacy and safety in Chinese APC patients. Patients with APC who received ICIs between November 2018 to June 2021 were enrolled in this retrospective study. The efficacy end points included overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR) and adverse events (AEs). This study included 104 patients and the median OS (mOS) and median PFS (mPFS) were 9.1 and 5.4 months, respectively. In the subgroup analyses, the mOS was longer for patients receiving combined radiotherapy than for those that didn't (13.8 vs 7.0 months, p < .001), whereas the mPFS was also longer, and the ORR and DCR were higher. Specifically, the mOS was longer for patients who had received a combination of chemotherapy than for those combined with targeted therapy (11.6 vs 5.6 months, p = .002), with the mPFS being also longer. ICIs as a first-line treatment could resulted to better survival. The mOS was longer for patients with a high TMB compared to those with low (19.3 vs 7.2 months, p = .004), whereas AEs were considered to be tolerable. The combination therapy of ICIs was proved to be safe and effective for treating APC, especially the combination of chemotherapy and radiotherapy, which would benefit from additional prospective studies.
先前的临床研究表明,单药检查点抑制剂在晚期胰腺癌(APC)中并未产生预期的效果。直到今天,对于它们在真实环境中的表现知之甚少。因此,在本研究中,我们研究了 ICIs 在接受治疗的中国 APC 患者中的疗效和安全性。这项回顾性研究纳入了自 2018 年 11 月至 2021 年 6 月期间接受 ICIs 治疗的 APC 患者。疗效终点包括总生存期(OS)、无进展生存期(PFS)、客观缓解率(ORR)、疾病控制率(DCR)和不良事件(AEs)。本研究共纳入 104 例患者,中位 OS(mOS)和中位 PFS(mPFS)分别为 9.1 个月和 5.4 个月。在亚组分析中,接受联合放疗的患者 mOS 长于未接受联合放疗的患者(13.8 个月比 7.0 个月,p<0.001),mPFS 也较长,ORR 和 DCR 较高。具体而言,接受化疗联合治疗的患者 mOS 长于接受靶向治疗联合治疗的患者(11.6 个月比 5.6 个月,p=0.002),mPFS 也更长。ICIs 作为一线治疗可能会带来更好的生存。TMB 较高的患者 mOS 长于 TMB 较低的患者(19.3 个月比 7.2 个月,p=0.004),且 AEs 被认为是可耐受的。ICI 联合治疗被证明对治疗 APC 是安全有效的,尤其是化疗和放疗的联合治疗,这将得益于进一步的前瞻性研究。