NRG-BN002:Ipilimumab、Nivolumab 及联合疗法在新诊断的 GBM 患者中的 I 期研究。

IF 16.4 1区 医学 Q1 CLINICAL NEUROLOGY
Andrew E Sloan, Kathryn Winter, Mark R Gilbert, Kenneth Aldape, Serah Choi, Patrick Y Wen, Nicholas Butowski, Fabio M Iwamoto, Raju R Raval, Alfredo D Voloschin, Carlos Kamiya-Matsuoka, Minhee Won, Minesh P Mehta
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引用次数: 0

摘要

背景:免疫检查点抑制剂(ICIs)对多种实体瘤有疗效,但对胶质母细胞瘤(GBM)的疗效有限。这项研究评估了抗CTLA-4和抗PD-1 ICIs单药或联合用药在完成标准放化疗后新诊断的GBM中的安全性,随后打算在这种情况下测试联合ICIs:主要终点是切除和化疗后新诊断为单灶、胸骨上GBM的成人患者的剂量限制性毒性(DLT)。对伊匹单抗和尼伐单抗进行了单独和联合试验,并根据DLT结果计划扩大队列:9家机构共招募了32名患者;每组DLT评估队列中有6名患者,扩增队列中有14名患者。中位年龄:55 岁,67.7% 为男性,83.9% 为白人。治疗耐受性良好,4级事件占16%;联合用药的毒性没有意外增加,没有5级事件。每种单药治疗中都出现了一次 DLT,而联合治疗中未出现任何 DLT,因此扩大了联合治疗的应计范围。中位随访时间为 19.6 个月。所有接受联合治疗的患者的中位总生存期(OS)和无进展生存期(PFS)分别为20.7个月和16.1个月:IPI和NIVO联合TMZ辅助治疗新诊断的GBM是安全和可耐受的,其毒性与其他癌症相似。IPI+NIVO联合用药的毒性并不比单一用药大。这些结果支持进行后续疗效试验,在 II/III 期试验中对新诊断的 GBM 患者进行 ICIs 联合用药试验。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
NRG-BN002: Phase I study of ipilimumab, nivolumab, and the combination in patients with newly diagnosed glioblastoma.

Background: Immune checkpoint inhibitors (ICIs) have efficacy in several solid tumors but limited efficacy in glioblastoma (GBM). This study evaluated the safety of anti-CTLA-4 and anti-PD-1 ICIs alone or in combination in newly diagnosed GBM after completion of standard radiochemotherapy with the subsequent intent to test combinatorial ICIs in this setting.

Methods: The primary endpoint was dose-limiting toxicity (DLT) for adults with unifocal, supratentorial newly diagnosed GBM after resection and chemoradiation. Ipilimumab and nivolumab were tested separately and in combination with a planned expansion cohort dependent upon DLT results.

Results: Thirty-two patients were enrolled at 9 institutions: 6 to each DLT assessment cohort and 14 to the expansion cohort. Median age: 55 years, 67.7% male, 83.9% White. Treatment was well tolerated with 16% Grade 4 events; the combination did not have unexpectedly increased toxicity, with no Grade 5 events. One DLT was seen in each single-agent treatment; none were observed in the combination, leading to expanded accrual of the combined treatment. The median follow-up was 19.6 months. For all patients receiving combination treatment, median overall survival (OS) and progression-free survival (PFS) were 20.7 and 16.1 months, respectively.

Conclusions: IPI and NIVO are safe and tolerable with toxicities similar to those noted with other cancers when given in combination with adjuvant temozolomide for newly diagnosed GBM. Combination IPI + NIVO is not substantially more toxic than single agents. These results support a subsequent efficacy trial to test the combination of ICIs in Phase II/III for patients with newly diagnosed GBM.

Clinicaltrials.gov registration: NCT02311920.

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来源期刊
Neuro-oncology
Neuro-oncology 医学-临床神经学
CiteScore
27.20
自引率
6.30%
发文量
1434
审稿时长
3-8 weeks
期刊介绍: Neuro-Oncology, the official journal of the Society for Neuro-Oncology, has been published monthly since January 2010. Affiliated with the Japan Society for Neuro-Oncology and the European Association of Neuro-Oncology, it is a global leader in the field. The journal is committed to swiftly disseminating high-quality information across all areas of neuro-oncology. It features peer-reviewed articles, reviews, symposia on various topics, abstracts from annual meetings, and updates from neuro-oncology societies worldwide.
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