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非小细胞肺癌患者二线治疗中多西他赛(联合雷莫芦单抗)治疗的反应研究。

Investigation of response of patients with non-small cell lung cancer to docetaxel (plus ramucirumab) therapy in second-line treatment.

机构信息

Department of Respiratory Medicine, Kanazawa Medical University, Ishikawa, Japan.

出版信息

Thorac Cancer. 2023 Dec;14(36):3549-3555. doi: 10.1111/1759-7714.15161. Epub 2023 Nov 14.

Abstract

BACKGROUND

Several options for second-line therapy are available for patients with advanced non-small cell lung cancer (NSCLC); however, the optimal therapy remains unclear. Docetaxel (DTX) monotherapy and DTX plus ramucirumab (RAM) are the recommended second-line treatment options. However, the efficacy of these treatments remains unsatisfactory. The aim of this study was to identify the clinical characteristics of patients with NSCLC who respond to DTX or DTX + RAM and factors that predict response.

METHODS

Patients with NSCLC treated with DTX or DTX + RAM after second-line therapy were retrospectively analyzed. Patients were compared with those who responded or did not respond to the post-treatment efficacy assessment.

RESULTS

Of 53 patients, 12 (22.6%) had lung cancer that responded to DTX or DTX + RAM therapy (response group). Multivariate analysis identified the absence of immune checkpoint inhibitors (ICIs) in the immediate prior therapy and a reduced dose of DTX after the second cycle as significant independent risk factors predicting nonresponse to DTX and DTX + RAM therapy in patients with NSCLC. The overall survival was significantly longer in the response group compared to the nonresponse group (p = 0.016).

CONCLUSIONS

Our results suggest that DTX and DTX + RAM therapies immediately after treatment with ICI-containing regimens as well as continuation of DTX without dose reduction after the second cycle may increase the response rate and prolong survival in patients with NSCLC.

摘要

背景

对于晚期非小细胞肺癌(NSCLC)患者,有几种二线治疗选择;然而,最佳治疗方法仍不明确。多西他赛(DTX)单药治疗和 DTX 联合雷莫芦单抗(RAM)是推荐的二线治疗选择。然而,这些治疗的疗效仍不理想。本研究旨在确定对 DTX 或 DTX+RAM 有反应的 NSCLC 患者的临床特征和预测反应的因素。

方法

回顾性分析了接受二线治疗后接受 DTX 或 DTX+RAM 治疗的 NSCLC 患者。将患者与对治疗后疗效评估有反应或无反应的患者进行比较。

结果

在 53 名患者中,有 12 名(22.6%)对 DTX 或 DTX+RAM 治疗有反应(反应组)。多变量分析确定,在即时的前序治疗中未使用免疫检查点抑制剂(ICI)和在第二周期后 DTX 的剂量减少是预测 NSCLC 患者对 DTX 和 DTX+RAM 治疗无反应的显著独立危险因素。与无反应组相比,反应组的总生存期明显更长(p=0.016)。

结论

我们的结果表明,在含有 ICI 的方案治疗后立即使用 DTX 和 DTX+RAM 治疗,以及在第二周期后不减少 DTX 剂量,可能会增加 NSCLC 患者的反应率并延长生存期。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9842/10733157/2d5eea7f9b92/TCA-14-3549-g001.jpg

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