The feasibility of the deep hypothermal cryotherapy plus immune checkpoint inhibitor for treatment of severe malignant central airway obstruction.

IF 2.1 4区医学 Q3 ONCOLOGY

Chinese clinical oncology Pub Date : 2024-12-01 DOI:10.21037/cco-24-74

Zhibing Luo, Changwen Deng, Shaoyong Gao, Xiaodong Wu, Xia Fang, Xiaoping Zhu, Qiang Li, Wujian Xu

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引用次数: 0

Abstract

Background: The recurrence shortly after interventional therapy poses a great challenge in managing malignant central airway obstruction (MCAO). While cryotherapy has shown potential benefits when combined with immunotherapy in lung cancer, its effectiveness for improving local control of malignant central airway tumors is not well understood. This study aims to evaluate the clinical efficacy and safety of combining these strategies.

Methods: A total of 12 patients with MCAO who had been treated with a combination of cryotherapy and immune checkpoint inhibitors (ICIs) were compiled for analysis in a tertiary hospital in Shanghai East Hospital, China. The primary endpoint is the duration of efficacy (DoE) for MACO after the combined therapy, which was defined as the time interval of the airway stayed patency without additional repeated interventional treatment. Secondary endpoints encompassed an assessment of objective response rate, overall survival and the adverse events.

Results: Twelve patients received a combination therapy between January 2021 and December 2023. Median age was 66 years, 91.7% male. Fifty percent were squamous carcinoma. 50.0% had medium to low programmed cell death-ligand 1 (PD-L1) levels. 41.7% patients' performance status scored higher than 2. 91.7% (11/12) of the patients objectively respond to the combined therapy, with a median DoE of 10.0 (95% confidence interval: 3.7-21.7) months. The 6-, 12- and 18-month survival rate was 75.0%, 50.0% and 41.8%, respectively. The most common adverse event was granulation. Other events included mild rash, pneumonitis, and hypothyroidism. No severe procedure-related adverse events occurred.

Conclusions: In patients with endoluminal or mixed MCAO, our findings suggest that combining endobronchial cryotherapy with ICIs may help maintain airway patency, offering a promising preliminary signal for this therapeutic approach.

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深度低温冷冻联合免疫检查点抑制剂治疗严重恶性中央气道阻塞的可行性。

背景：介入治疗后的复发对恶性中央气道阻塞（MCAO）的治疗提出了很大的挑战。虽然冷冻疗法与免疫疗法联合治疗肺癌显示出潜在的益处，但其在改善恶性中央气道肿瘤局部控制方面的有效性尚不清楚。本研究旨在评价这些策略联合使用的临床疗效和安全性。方法：收集中国上海东方医院某三级医院冷冻联合免疫检查点抑制剂（ICIs）治疗的MCAO患者12例。主要终点为联合治疗后MACO的疗效持续时间（duration of efficacy, DoE），定义为在没有额外重复介入治疗的情况下气道保持通畅的时间间隔。次要终点包括客观缓解率、总生存期和不良事件的评估。结果：12例患者在2021年1月至2023年12月期间接受了联合治疗。中位年龄为66岁，91.7%为男性。50%为鳞状癌。50.0%的患者程序性细胞死亡配体1 （PD-L1）水平中低。41.7%的患者表现状态评分在2分以上。91.7%（11/12）的患者对联合治疗有客观反应，中位DoE为10.0（95%置信区间：3.7-21.7）个月。6、12、18个月生存率分别为75.0%、50.0%、41.8%。最常见的不良反应是肉芽肿。其他事件包括轻度皮疹、肺炎和甲状腺功能减退。未发生严重的手术相关不良事件。结论：在腔内或混合型MCAO患者中，我们的研究结果表明，联合支气管内冷冻治疗与ICIs可能有助于维持气道通畅，为这种治疗方法提供了一个有希望的初步信号。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Chinese clinical oncology ONCOLOGY-

CiteScore

3.90

自引率

0.00%

发文量

期刊介绍： The Chinese Clinical Oncology (Print ISSN 2304-3865; Online ISSN 2304-3873; Chin Clin Oncol; CCO) publishes articles that describe new findings in the field of oncology, and provides current and practical information on diagnosis, prevention and clinical investigations of cancer. Specific areas of interest include, but are not limited to: multimodality therapy, biomarkers, imaging, tumor biology, pathology, chemoprevention, and technical advances related to cancer. The aim of the Journal is to provide a forum for the dissemination of original research articles as well as review articles in all areas related to cancer. It is an international, peer-reviewed journal with a focus on cutting-edge findings in this rapidly changing field. To that end, Chin Clin Oncol is dedicated to translating the latest research developments into best multimodality practice. The journal features a distinguished editorial board, which brings together a team of highly experienced specialists in cancer treatment and research. The diverse experience of the board members allows our editorial panel to lend their expertise to a broad spectrum of cancer subjects.