Suppr超能文献

诱导化疗免疫疗法治疗局部晚期下咽癌的临床疗效:一项前瞻性Ⅱ期研究

[Clinical efficacy of induction chemoimmunotherapy for locally advanced hypopharyngeal carcinoma: a prospective phase Ⅱ study].

作者信息

Gong H L, Tian S, Ding H, Tao L, Wang L, Wang J, Wang T, Zhang M, Shi Y, Xu C Z, Wu C P, Wang S Z, Zhou L

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, Eye & ENT Hospital, Fudan University, Shanghai 200031, China.

Department of Radiation Oncology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China.

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2024 Apr 7;59(4):350-356. doi: 10.3760/cma.j.cn115330-20240129-00056.

Abstract

To evaluate the objective response rate (ORR) of induction chemoimmunotherapy with camrelizumab plus TPF (docetaxel, cisplatin, and capecitabine) for locally advanced hypopharyngeal squamous cell carcinoma (LA HSCC) and potential predictive factors for ORR. A single-center, prospective, phase 2 and single-arm trial was conducted for evaluating antitumor activity of camrelizumab+TPF(docetaxel+cisplatin+capecitabine) for LA HSCC between May 21, 2021 and April 15, 2023, patients admitted to the Eye & ENT Hospital affiliated with Fudan University. The primary endpoint was ORR, and enrolled patients with LA HSCC at T3-4N0-3M0 received induction chemoimmunotherapy for three cycles: camrelizumab 200 mg day 1, docetaxel 75 mg/m day 1, cisplatin 25 mg/m days 1-3, and capecitabine 800 mg/m days 1-14. Patients were assigned to radioimmunotherapy when they had complete response or partial response (PR)>70% (Group A), or assigned to surgery plus adjuvant radiotherapy/chemoradiotherapy when they had PR≤70% (Group B), and the responses were defined by using tumor volume evaluation system. Tumor diameter was also used to assess the treatment responses by Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. Use SPSS 23.0 software was used to analyze the data. A total of 51 patients were enrolled who underwent the induced chemoimmunotherapy for three cycles, and all were males, aged 35-69 years old. After three cycles of induction immunochemotherapy, 42 (82.4%) patients existed in Group A (complete response or PR>70%) and 9 patients (17.6%) in Group B (PR≤70%), the ORR was 82.4%. The primary endpoint achieved expected main research objectives. Compared to the patients of Group A, the patients of Group B showed the higher T stage and the larger volume of primary tumor before induced immunochemotherapy, and also had the less regression of tumor volume after induced immunochemotherapy (all <0.05). The optimal cutoff value of pre-treatment tumor volume for predicting ORR was 39 cm. The T stage (=12.71, 95%: 1.4-112.5, =0.022) and the volume (=7.1, 95%: 1.4-36.8, =0.018) of primary tumor were the two main factors affecting ORR rate of induction chemoimmunotherapy. The induction chemoimmunotherapy with camrelizumab plus TPF shows an encouraging antitumor efficacy in LA HSCC.

摘要

评估卡瑞利珠单抗联合TPF(多西他赛、顺铂和卡培他滨)诱导化疗免疫疗法治疗局部晚期下咽鳞状细胞癌(LA HSCC)的客观缓解率(ORR)及ORR的潜在预测因素。2021年5月21日至2023年4月15日,对复旦大学附属眼耳鼻喉科医院收治的LA HSCC患者进行了一项单中心、前瞻性、2期单臂试验,以评估卡瑞利珠单抗+TPF(多西他赛+顺铂+卡培他滨)对LA HSCC的抗肿瘤活性。主要终点为ORR,入组的T3-4N0-3M0期LA HSCC患者接受3个周期的诱导化疗免疫疗法:卡瑞利珠单抗200 mg第1天,多西他赛75 mg/m²第1天,顺铂25 mg/m²第1-3天,卡培他滨800 mg/m²第1-14天。患者在完全缓解或部分缓解(PR)>70%时接受放射免疫治疗(A组),PR≤70%时接受手术加辅助放疗/化疗(B组),采用肿瘤体积评估系统定义缓解情况。还采用实体瘤疗效评价标准(RECIST)1.1版通过肿瘤直径评估治疗反应。使用SPSS 23.0软件分析数据。共入组51例接受3个周期诱导化疗免疫疗法的患者,均为男性,年龄35-69岁。3个周期诱导免疫化疗后,A组(完全缓解或PR>70%)有42例(82.4%)患者,B组(PR≤70%)有9例(17.6%)患者,ORR为82.4%。主要终点达到预期主要研究目标。与A组患者相比,B组患者诱导免疫化疗前T分期更高、原发肿瘤体积更大,诱导免疫化疗后肿瘤体积缩小也更少(均P<0.05)。预测ORR的治疗前肿瘤体积最佳截断值为39 cm³。原发肿瘤的T分期(χ²=12.71,95%CI:1.4-112.5,P=0.022)和体积(χ²=7.1,95%CI:1.4-36.8,P=0.018)是影响诱导化疗免疫疗法ORR率的两个主要因素。卡瑞利珠单抗联合TPF诱导化疗免疫疗法在LA HSCC中显示出令人鼓舞的抗肿瘤疗效。

文献检索

告别复杂PubMed语法,用中文像聊天一样搜索,搜遍4000万医学文献。AI智能推荐,让科研检索更轻松。

立即免费搜索

文件翻译

保留排版,准确专业,支持PDF/Word/PPT等文件格式,支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述,25分钟生成高质量综述,智能提取关键信息,辅助科研写作。

立即免费体验