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信迪利单抗联合 HPV 疫苗用于复发性或转移性宫颈癌。

Sintilimab plus HPV vaccine for recurrent or metastatic cervical cancer.

机构信息

Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China

Yangzhou University, Yangzhou, Jiangsu, China.

出版信息

J Immunother Cancer. 2024 Nov 27;12(11):e009898. doi: 10.1136/jitc-2024-009898.

DOI:10.1136/jitc-2024-009898
PMID:39608975
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11603683/
Abstract

PURPOSE

Recurrent or metastatic cervical cancer (r/m CC) presents limited treatment options for patients failed or progressed quickly following first-line therapy. This study investigated the potential of sintilimab with a prophylactic human papillomavirus (HPV) quadrivalent vaccine as a second-line treatment for r/m CC.

METHODS

In this phase 2 clinical trial, patients with r/m CC previously unresponsive or intolerant to standard treatments for metastatic or recurrent lesions were enrolled. Participants received sintilimab (3 mg/kg for body weight <60 kg; 200 mg for ≥60 kg) every 3 weeks until 24 months or 35 cycles and 3 doses of the HPV quadrivalent vaccine (initial dose prior to sintilimab initiation, with subsequent doses at 2 and 6 months). The primary endpoint was the objective response rate (ORR). A Simon two-stage optimal design was used.

RESULTS

From October 2019 to October 2022, 13 patients with r/m CC were enrolled. ORR achieved 53.8% (95% CI 25.1% to 80.8%), and the disease control rate was 76.9% (95% CI 46.2% to 95.0%). Median follow-up duration was 16.07 months (range: 3.64-48.2 months), and median progressive free survival was 7.16 months (95% CI 1.91 -not applicable (NA)). The median overall survival (OS) was not reached (95% CI 9.89 -NA). Hypothyroidism (15.6%) was the most common treatment-related adverse event (AE). No grade 3 or above AEs were observed.

CONCLUSIONS

This study suggests the combination of sintilimab plus prophylactic HPV vaccine offers a potentially promising therapeutic strategy for patients with r/m CC unresponsive or intolerant to standard therapies.Trial registration numberNCT04096911.

摘要

目的

复发或转移性宫颈癌(r/m CC)患者在一线治疗失败或快速进展后,治疗选择有限。本研究旨在探讨信迪利单抗联合预防性 HPV 四价疫苗作为 r/m CC 二线治疗的潜力。

方法

这是一项 2 期临床试验,招募了既往对转移性或复发性病变的标准治疗无反应或不耐受的 r/m CC 患者。参与者接受信迪利单抗(体重<60kg 者为 3mg/kg;≥60kg 者为 200mg)每 3 周一次,持续 24 个月或 35 个周期,并接受 3 剂 HPV 四价疫苗(在开始使用信迪利单抗前给予首剂,随后在 2 个月和 6 个月时给予 2 剂)。主要终点为客观缓解率(ORR)。采用 Simon 两阶段最优设计。

结果

2019 年 10 月至 2022 年 10 月,共纳入 13 例 r/m CC 患者。ORR 为 53.8%(95%CI:25.1%80.8%),疾病控制率为 76.9%(95%CI:46.2%95.0%)。中位随访时间为 16.07 个月(范围:3.6448.2 个月),中位无进展生存期为 7.16 个月(95%CI:1.91无)。中位总生存期(OS)尚未达到(95%CI:9.89~无)。最常见的治疗相关不良事件(AE)是甲状腺功能减退(15.6%)。未观察到 3 级或以上的 AE。

结论

本研究表明,信迪利单抗联合预防性 HPV 疫苗为标准治疗无反应或不耐受的 r/m CC 患者提供了一种有前景的治疗策略。

试验注册

NCT04096911。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c2b/11603683/4d5ccac15d46/jitc-12-11-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c2b/11603683/b425fba96a04/jitc-12-11-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c2b/11603683/4d5ccac15d46/jitc-12-11-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c2b/11603683/b425fba96a04/jitc-12-11-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c2b/11603683/4d5ccac15d46/jitc-12-11-g002.jpg

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