The necessity of adjuvant surgery for patients with high-risk chemorefractory or relapsed gestational choriocarcinoma with complete remission after anti-PD-1 therapy.

IF 3.4 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Jiayuan Zhao, Dan Wang, Yonglan He, Xirun Wan, Jun Zhao, Junjun Yang, Yang Xiang
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引用次数: 0

Abstract

Objective: Anti-programmed cell death protein 1 (PD-1) therapy has demonstrated favorable therapeutic responses in patients with chemorefractory gestational trophoblastic neoplasia. The need for combined surgery to remove resistant foci in patients treated with anti-PD-1 therapy after complete remission (CR), however, has not been investigated. We therefore compared the prognosis of patients with high-risk chemorefractory or relapsed choriocarcinoma who underwent anti-PD-1 therapy with or without surgery.

Methods: Patients with high-risk chemorefractory or relapsed choriocarcinoma who experienced CR following immunotherapy in conjunction with either surgical or non-surgical interventions were selected at Peking Union Medical College Hospital (PUMCH) between August 2018 and December 2023. Study endpoints included progression-free survival (PFS) and overall survival (OS). The results were analyzed using Mann-Whitney U tests and Kaplan-Meier analysis.

Results: Forty-three patients who received andi-PD-1 therapy were enrolled in this study, including 18 patients with surgery and 25 without. Most of the foci in the surgery group were solitary (77.8%). The median maximum diameters of resistant foci before immunotherapy were 2.9 (0.7-7.3) cm and 1.4 (0.8-11.2) cm in the surgery and non-surgery groups, respectively (p=0.184). The 2-year PFS rate was both 91.5% in the non-surgery group and 90.9% in the surgery group. The 2-year and 3-year OS rates were 100.0% in both groups. There was no significant difference in PFS (p=0.849) or OS (p=0.371) between the 2 groups.

Conclusion: These results suggest that surgical resection of drug-resistant lesions may not be necessary in patients with high-risk chemorefractory or relapsed choriocarcinoma who achieve CR after anti-PD-1 therapy.

抗pd -1治疗后完全缓解的高危化疗难治或复发妊娠绒毛膜癌患者辅助手术的必要性
目的:抗程序性细胞死亡蛋白1 (PD-1)治疗在化疗难治性妊娠滋养细胞瘤患者中显示出良好的治疗效果。然而,在完全缓解(CR)后接受抗pd -1治疗的患者是否需要联合手术切除耐药灶尚未研究。因此,我们比较了高危化疗难治性或复发绒毛膜癌患者接受抗pd -1治疗加或不加手术的预后。方法:选择2018年8月至2023年12月在北京协和医院(PUMCH)接受免疫治疗联合手术或非手术干预后发生CR的高危化疗难治或复发绒毛膜癌患者。研究终点包括无进展生存期(PFS)和总生存期(OS)。采用Mann-Whitney U检验和Kaplan-Meier分析对结果进行分析。结果:43例接受抗pd -1治疗的患者纳入本研究,其中18例接受手术治疗,25例未接受手术治疗。手术组病灶多为孤立灶(77.8%)。手术组和非手术组免疫治疗前耐药灶的中位最大直径分别为2.9 (0.7-7.3)cm和1.4 (0.8-11.2)cm (p=0.184)。非手术组2年PFS为91.5%,手术组为90.9%。两组2年和3年的总生存率均为100.0%。两组患者PFS (p=0.849)、OS (p=0.371)差异无统计学意义。结论:这些结果表明,在抗pd -1治疗后达到CR的高危化疗难治性或复发绒毛膜癌患者,可能不需要手术切除耐药病变。
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
Journal of Gynecologic Oncology
Journal of Gynecologic Oncology ONCOLOGY-OBSTETRICS & GYNECOLOGY
CiteScore
6.00
自引率
2.60%
发文量
84
审稿时长
>12 weeks
期刊介绍: The Journal of Gynecologic Oncology (JGO) is an official publication of the Asian Society of Gynecologic Oncology. Abbreviated title is ''J Gynecol Oncol''. It was launched in 1990. The JGO''s aim is to publish the highest quality manuscripts dedicated to the advancement of care of the patients with gynecologic cancer. It is an international peer-reviewed periodical journal that is published bimonthly (January, March, May, July, September, and November). Supplement numbers are at times published. The journal publishes editorials, original and review articles, correspondence, book review, etc.
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