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抗程序性死亡-1 抗体联合治疗在中国晚期或转移性胃或胃食管结合部癌患者中的疗效和安全性:一项真实世界研究。

Efficacy and safety of anti-programmed death-1 antibody-based combination therapy in advanced or metastatic gastric or gastroesophageal junction cancer in Chinese patients: A real-world study.

机构信息

Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China.

Department of Oncology, Yantai Hospital of Traditional Chinese Medicine, Yantai, Shandong, China.

出版信息

Sci Prog. 2024 Jul-Sep;107(3):368504241272703. doi: 10.1177/00368504241272703.

Abstract

PURPOSE

Programmed death-1 antibody plus chemotherapy has gained approval for the treatment for (human epidermal growth factor receptor 2 negative locally advanced or metastatic gastric or gastroesophageal junction cancer. This study aims to analyze the efficacy and safety of anti-programmed death-1 antibody combined with chemo- or anti-angiogenesis therapy in Chinese patients with advanced or metastatic gastric or gastroesophageal junction cancer in a real-world setting.

METHODS

In total, 122 patients treated with anti-programmed death-1 antibody-based combination therapy between April 2019 and December 2021 were encompassed. Clinical outcomes and safety profile were measured and analyzed.

RESULTS

In the whole cohort, median overall survival was 17.2 months, median progression-free survival was 10.9 months, and median duration of response was 9.4 months. Notably, in the first-line patients, the median overall survival was not reached, median progression-free survival was 14.8 months, objective response rate was 68.4%. In the second-line group, median overall survival, median progression-free survival, median duration of response, and objective response rate were 10.9 months, 5.9 months, 4.5 months, and 41.5%, respectively. Treatment-related adverse events of any grade were observed in 28.2% of the overall cohort, primarily affecting the hematological and liver function. Grade 3 or 4 adverse events were mainly characterized by increased levels of aspartate aminotransferase, alanine aminotransferase, along with decreased lymphocyte and white blood cells, as well as anemia.

CONCLUSIONS

Patients in our cohort experienced a clinical benefit from anti-programmed death-1 antibody-combined treatment in first-line treatment settings, with acceptable treatment-related adverse events. The benefit of anti-programmed death-1 antibody combined with chemo- or anti-angiogenesis treatment to the second-line patients should be further confirmed by large multi-center randomized, controlled clinical trials.

摘要

目的

程序性死亡-1 抗体联合化疗已获批用于治疗(人表皮生长因子受体 2 阴性局部晚期或转移性胃或胃食管交界处癌。本研究旨在分析抗程序性死亡-1 抗体联合化疗或抗血管生成治疗在中国晚期或转移性胃或胃食管交界处癌患者中的疗效和安全性。

方法

共纳入 122 例 2019 年 4 月至 2021 年 12 月期间接受抗程序性死亡-1 抗体联合治疗的患者。测量并分析了临床结局和安全性概况。

结果

在整个队列中,中位总生存期为 17.2 个月,中位无进展生存期为 10.9 个月,中位缓解持续时间为 9.4 个月。值得注意的是,在一线患者中,中位总生存期未达到,中位无进展生存期为 14.8 个月,客观缓解率为 68.4%。在二线组中,中位总生存期、中位无进展生存期、中位缓解持续时间和客观缓解率分别为 10.9 个月、5.9 个月、4.5 个月和 41.5%。总体队列中观察到任何等级的治疗相关不良事件发生率为 28.2%,主要影响血液学和肝功能。3 级或 4 级不良事件主要表现为天冬氨酸转氨酶、丙氨酸转氨酶水平升高,以及淋巴细胞和白细胞减少以及贫血。

结论

本队列患者在一线治疗中从抗程序性死亡-1 抗体联合治疗中获得了临床获益,且治疗相关不良事件可接受。抗程序性死亡-1 抗体联合化疗或抗血管生成治疗对二线患者的益处应通过大型多中心随机对照临床试验进一步证实。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e8c/11339938/cd1bd95717ee/10.1177_00368504241272703-fig1.jpg

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