Xi Pu, Sun Peng, Chen Miao, Yao Zehui, Zhu Qi, Li Shengping, He Chaobin
Department of Pancreatobiliary Surgery, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.
Department of Anesthesiology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China.
Front Immunol. 2025 Jul 8;16:1620988. doi: 10.3389/fimmu.2025.1620988. eCollection 2025.
Irreversible electroporation (IRE) has shown promise in improving survival outcomes and activating the immune response in patients with locally advanced pancreatic cancer (LAPC). Given these immune-enhancing effects, we hypothesized that combining IRE with immune checkpoint inhibitors may further improve treatment outcomes. This study aimed to evaluate the efficacy and safety of IRE combined with anti-PD-1 immunotherapy versus IRE alone in patients with LAPC.
In this retrospective study, LAPC patients treated either with IRE plus toripalimab (240 mg administered 7 days post-IRE) or with IRE alone were included. Propensity score matching (PSM) analyses were employed for analysis. Clinical outcomes including overall survival (OS), progression-free survival (PFS), and treatment-related adverse events were analyzed and compared between the groups.
A total of 108 patients from August 2015 and Match 2024 from SYSUCC cohort were identified with 76 undergoing IRE and 32 undergoing IRE and toripalimab in this study. After PSM, 96 patients consisting of 64 and 32 patients in the IRE and combination groups were enrolled. Clinical factors were all balanced between two groups. Patients receiving IRE combined with toripalimab showed significantly improved OS (35.03 months; 95% CI: 30.94-39.13 vs. 15.87 months; 95% CI: 8.99-22.74; P=0.014) and PFS (14.33months; 95% CI: 11.19-17.47 vs. 7.47 months; 95% CI: 3.86-11.08; P=0.022) compared to those receiving IRE alone. No treatment-related mortality was reported in either group and no statistically significant differences were observed in terms of complications and adverse events between two groups (all P>0.05).
The combination of IRE and anti-PD-1 immunotherapy was associated with improved survival outcomes and acceptable safety profiles compared to IRE alone in patients with LAPC. Further investigation through prospective trials is warranted.
不可逆电穿孔（IRE）在改善局部晚期胰腺癌（LAPC）患者的生存结局和激活免疫反应方面已显示出前景。鉴于这些免疫增强作用，我们假设将IRE与免疫检查点抑制剂联合使用可能会进一步改善治疗效果。本研究旨在评估IRE联合抗PD-1免疫疗法与单独使用IRE治疗LAPC患者的疗效和安全性。
在这项回顾性研究中，纳入了接受IRE加托瑞帕利单抗（IRE后7天给予240mg）或单独接受IRE治疗的LAPC患者。采用倾向评分匹配（PSM）分析进行分析。分析并比较两组之间的临床结局，包括总生存期（OS）、无进展生存期（PFS）和治疗相关不良事件。
本研究共纳入了2015年8月至2024年5月来自中山大学肿瘤防治中心队列的108例患者，其中76例接受IRE治疗，32例接受IRE加托瑞帕利单抗治疗。经过PSM后，纳入了96例患者，IRE组和联合治疗组分别为64例和32例。两组的临床因素均达到平衡。与单独接受IRE治疗的患者相比，接受IRE联合托瑞帕利单抗治疗的患者的OS（35.03个月；95%CI：30.94-39.13 vs. 15.87个月；95%CI：8.99-22.74；P=0.014）和PFS（14.33个月；95%CI：11.19-17.47 vs. 7.47个月；95%CI：3.86-11.08；P=0.022）均有显著改善。两组均未报告与治疗相关的死亡，两组在并发症和不良事件方面未观察到统计学上的显著差异（所有P>0.05）。
与单独使用IRE相比，IRE联合抗PD-1免疫疗法在LAPC患者中与改善的生存结局和可接受的安全性相关。有必要通过前瞻性试验进行进一步研究。
