帕博利珠单抗治疗后晚期食管鳞癌患者使用紫杉烷类药物的影响。
Impact of taxanes after PD-1 blockade exposure in advanced esophageal squamous cell carcinoma.
机构信息
Department of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan.
Department of Thoracic Oncology, National Cancer Center Hospital, Chuo-Ku, Japan.
出版信息
Esophagus. 2024 Oct;21(4):539-545. doi: 10.1007/s10388-024-01085-5. Epub 2024 Sep 2.
BACKGROUND
Programmed cell death-1 (PD-1) blockade improves survival in patients with advanced esophageal squamous cell carcinoma (ESCC). However, the efficacy of taxanes after exposure to PD-1 blockade remains unclear in patients with advanced ESCC.
METHODS
We retrospectively analyzed the clinical outcomes of advanced ESCC patients treated with taxanes (paclitaxel or docetaxel) with/without prior exposure to PD-1 blockade (Exposed /Naïve group) at National Cancer Center Hospital from June 2016 to December 2020.
RESULTS
Ninety-nine patients (Exposed group, n = 32; Naïve group, n = 67) were included. The objective response rate (ORR) of the Exposed group was significantly higher than that of the Naïve group (37.5% vs. 13.4%, p = 0.009). The median progression-free survival was similar between the Exposed and Naïve groups (3.8 vs. 2.8 months, HR 1.12, 95% CI 0.65-1.86, p = 0.66). PD-1 blockade exposure independently predicated higher ORR to taxanes in multivariate analysis. Grade ≥ 3 adverse events were comparable between the Exposed and Naïve groups (45.8% vs. 40.3%, p = 0.64).
CONCLUSIONS
Taxanes following PD-1 blockade in advanced ESCC showed a higher ORR but similar PFS compared to taxanes without prior PD-1 exposure.
背景
程序性死亡受体-1（PD-1）阻断可改善晚期食管鳞癌（ESCC）患者的生存。然而，在晚期 ESCC 患者中，PD-1 阻断后使用紫杉烷的疗效尚不清楚。
方法
我们回顾性分析了 2016 年 6 月至 2020 年 12 月在国家癌症中心医院接受紫杉烷（紫杉醇或多西他赛）治疗的晚期 ESCC 患者的临床结局，这些患者之前是否接受过 PD-1 阻断（暴露组/未暴露组）。
结果
共纳入 99 例患者（暴露组，n=32；未暴露组，n=67）。暴露组的客观缓解率（ORR）明显高于未暴露组（37.5% vs. 13.4%，p=0.009）。暴露组和未暴露组的中位无进展生存期相似（3.8 个月 vs. 2.8 个月，HR 1.12，95%CI 0.65-1.86，p=0.66）。多变量分析表明，PD-1 阻断暴露可独立预测紫杉烷的更高 ORR。暴露组和未暴露组的≥3 级不良事件发生率相似（45.8% vs. 40.3%，p=0.64）。
结论
晚期 ESCC 患者在接受 PD-1 阻断后使用紫杉烷治疗，其 ORR 较高，但与未接受 PD-1 暴露的紫杉烷相比，PFS 相似。
Zotero 插件