针对亚洲食管鳞状细胞癌患者的 Camrelizumab 真实世界环境前瞻性多中心研究。

IF 3.4 2区 医学 Q2 ONCOLOGY
Tingting Li, Yaqing Dai, Xiaobin Fu, Qunrong Cai, Dongmei Ke, Qiwei Yao, Jiancheng Li
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引用次数: 0

摘要

研究背景在这项研究中,我们旨在评估坎瑞珠单抗的实际疗效和安全性,并确定预测接受坎瑞珠单抗治疗的不可切除的晚期、复发性或转移性食管鳞状细胞癌(ESCC)患者治疗结果的临床实验室因素。方法:本文纳入了2019年10月1日至2022年10月1日期间接受坎瑞珠单抗单药治疗(n = 30)、坎瑞珠单抗+化疗(CT;n = 91)和坎瑞珠单抗+放疗(RT;n = 53)的174例不可切除的晚期、复发性或转移性ESCC患者:中位随访时间为20个月(1-34个月)。整个队列的中位无进展生存期(PFS)和总生存期(OS)分别为8个月[95%置信区间(CI),6.5-9.5个月]和14个月(95% CI,11.2-16.8个月)。经过多变量分析,接受超过4个周期的康瑞珠单抗被认为是更好的PFS[危险比(HR),0.56;95% CI,0.38-0.827;P = 0.004]和OS(HR,0.532;95% CI,0.341-0.83;P = 0.005)的独立预测因素。中差肺免疫预后指数(LIPI)被认为是较差PFS(HR,1.505;95% CI,1.032-2.196;P = 0.034)和OS(HR,1.657;95% CI,1.094-2.51;P = 0.017)的独立预测因子。坎瑞珠单抗单药组、坎瑞珠单抗+CT组和坎瑞珠单抗+RT组患者的疾病控制率分别为92.3%(95% CI,74.9-99.1%)、90.6%(95% CI,82.3-95.9%)和96.1%(95% CI,86.8-99.5%)。67名患者(38.5%)报告了3级或以上的治疗相关不良事件(AEs)。最常见的治疗相关不良事件是中性粒细胞计数减少(23.0%)、白细胞计数减少(19.5%)、贫血(7.5%)和肺炎(4.6%)。一名患者(0.6%)死于免疫检查点抑制剂诱发的心肌炎治疗相关不良反应:结论:无论是作为单一疗法还是作为联合疗法的一部分,卡姆雷珠单抗都是安全有效的。更长的PFS和OS与接受超过4个周期的康瑞珠单抗治疗和良好的LIPI有关。LIPI可作为接受坎瑞珠单抗+RT治疗的ESCC患者的预后生物标志物:试验注册:ClinicalTrial.gov Identifier:CHICTR2000039499。注册日期:2020 年 10 月 19 日。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prospective multicenter study of camrelizumab in real-world settings for asian patients with esophageal squamous cell carcinoma.

Background: In this study, we aimed to evaluate the real-world efficacy and safety of camrelizumab and identify clinicolaboratory factors that predict treatment outcomes in patients with unresectable advanced, recurrent, or metastatic esophageal squamous cell carcinoma (ESCC) receiving camrelizumab.

Methods: Herein, 174 patients with unresectable advanced, recurrent, or metastatic ESCC treated with camrelizumab monotherapy (n = 30), camrelizumab + chemotherapy (CT; n = 91), and camrelizumab + radiotherapy (RT; n = 53) between October 1, 2019 and October 1, 2022 were included.

Results: The median follow-up time was 20 months (range, 1-34 months). The median progression-free survival (PFS) and overall survival (OS) of the whole cohort were 8 months [95% confidence interval (CI), 6.5-9.5 months] and 14 months (95% CI, 11.2-16.8 months), respectively. After multivariate analysis, receiving > 4 cycles of camrelizumab was identified as an independent predictor of better PFS [hazard ratio (HR), 0.56; 95% CI, 0.38-0.827; P = 0.004] and OS (HR, 0.532; 95% CI, 0.341-0.83; P = 0.005). An intermediate-to-poor lung immune prognostic index (LIPI) was identified as an independent predictor of worse PFS (HR, 1.505; 95% CI, 1.032-2.196; P = 0.034) and OS (HR, 1.657; 95% CI, 1.094-2.51; P = 0.017). The disease control rate of patients in the camrelizumab monotherapy group, camrelizumab + CT group, and camrelizumab + RT group was 92.3% (95% CI, 74.9-99.1%), 90.6% (95% CI, 82.3-95.9%), and 96.1% (95% CI, 86.8-99.5%), respectively. The treatment-related adverse events (AEs) of grade 3 or higher were reported in 67 patients (38.5%). The most common treatment-related AEs were decreased neutrophil count (23.0%), decreased white blood cell count (19.5%), anemia (7.5%), and pneumonitis (4.6%). One patient (0.6%) died from a treatment-related AE of immune checkpoint inhibitor-induced myocarditis.

Conclusion: Camrelizumab was safe and effective as both monotherapy and part of a combination therapy. Longer PFS and OS were associated with receiving > 4 cycles of camrelizumab and having a good LIPI. LIPI can be used as a prognostic biomarker for ESCC patients receiving camrelizumab + RT.

Trial registration: ClinicalTrial.gov Identifier: CHICTR2000039499. Registered: 19th October 2020.

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来源期刊
BMC Cancer
BMC Cancer 医学-肿瘤学
CiteScore
6.00
自引率
2.60%
发文量
1204
审稿时长
6.8 months
期刊介绍: BMC Cancer is an open access, peer-reviewed journal that considers articles on all aspects of cancer research, including the pathophysiology, prevention, diagnosis and treatment of cancers. The journal welcomes submissions concerning molecular and cellular biology, genetics, epidemiology, and clinical trials.
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