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冷冻消融联合转移性黑色素瘤进展后免疫检查点抑制:一项 II 期试验。

Cryoablation and post-progression immune checkpoint inhibition in metastatic melanoma: a phase II trial.

机构信息

Division of Medical Oncology, Massachusetts General Hospital, Boston, MA, USA.

Harvard Medical School, Boston, MA, USA.

出版信息

Nat Commun. 2024 Aug 27;15(1):7357. doi: 10.1038/s41467-024-51722-x.

DOI:10.1038/s41467-024-51722-x
PMID:39191779
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11349953/
Abstract

Image-guided percutaneous cryoablation is an established minimally invasive oncologic treatment. We hypothesized that cryoablation may modify the immune microenvironment through direct modulation of the tumor, thereby generating an anti-tumor response in tumors refractory to immune checkpoint inhibition (ICI). In this non-randomized phase II single-center study (NCT03290677), subjects with unresectable melanoma progressing on ICI underwent cryoablation of an enlarging metastasis, and ICI was continued for a minimum of two additional cycles. The primary endpoints were safety, feasibility and tumor response in non-ablated lesions. From May 2018 through July 2020, 17 patients were treated on study. The study met its primary endpoints with the combination strategy found to be safe and feasible with an objective response rate of 23.5% and disease control rate of 41% (4 partial response, 3 stable disease). Our data support further study of this synergistic therapeutic approach.

摘要

影像引导经皮冷冻消融术是一种成熟的微创肿瘤治疗方法。我们假设冷冻消融术可能通过直接调节肿瘤来改变免疫微环境,从而在对免疫检查点抑制剂(ICI)耐药的肿瘤中产生抗肿瘤反应。在这项非随机的、单中心的 II 期研究(NCT03290677)中,接受 ICI 治疗但进展的不可切除黑色素瘤患者接受了增大转移灶的冷冻消融术,ICI 至少继续使用了两个额外的周期。主要终点是非消融病灶的安全性、可行性和肿瘤反应。从 2018 年 5 月到 2020 年 7 月,共有 17 名患者接受了治疗。研究结果达到了主要终点,该联合治疗策略被发现是安全可行的,客观缓解率为 23.5%,疾病控制率为 41%(4 例部分缓解,3 例疾病稳定)。我们的数据支持进一步研究这种协同治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e96/11349953/e57506ab6dd3/41467_2024_51722_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e96/11349953/84001d532d9c/41467_2024_51722_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e96/11349953/76d2605c12a2/41467_2024_51722_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e96/11349953/e57506ab6dd3/41467_2024_51722_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e96/11349953/84001d532d9c/41467_2024_51722_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e96/11349953/76d2605c12a2/41467_2024_51722_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e96/11349953/e57506ab6dd3/41467_2024_51722_Fig3_HTML.jpg

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