复发性子宫内膜癌患者的无铂间隔期和对铂再治疗或lenvatinib/pembrolizumab的反应：一项现实世界子宫内膜癌分子靶向治疗联合队列研究

IF 4.5 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Gynecologic oncology Pub Date : 2025-02-21 DOI:10.1016/j.ygyno.2025.02.013

Paulina J. Haight , Marilyn Sanchez , Samantha M. Thomas , Carson Smitherman , Casey Cosgrove , Victoria Bae-Jump , Sarah Crafton , Kari Hacker , Emily Ko , Thomas Krivak , Olivia Lara , Kathleen Moore , Mary M. Mullen , Bhavana Pothuri , Premal H. Thaker , Christina Washington , Rebecca Arend , Bradley Corr , Linda Duska , Amanda Jackson , Floor Backes

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引用次数: 0

摘要

目的：我们试图确定复发性子宫内膜癌患者无铂间期（PFI）与以铂为基础的化疗与lenvatinib/pembrolizumab再治疗的反应之间的关系。方法回顾性分析子宫肿瘤分子靶向治疗（ECMT2）复发性疾病的患者，如果他们接受了铂类化疗（辅助或首次复发）的一线治疗，然后再接受铂或lenvatinib/pembrolizumab的二线治疗。PFI定义为最后一次铂治疗日期到二线治疗开始日期之间的时间。患者按PFI≤12个月或>；12个月。用PFI分层后估计二线治疗的总缓解率（ORR）。结果在217例患者中，146例（67%）接受了铂治疗，71例（33%）接受了lenvatinib/pembrolizumab治疗。127例（59%）患者PFI≤12个月，84例（39%）患者PFI≤12个月。接受铂治疗的患者PFI比接受lenvatinib/pembrolizumab治疗的患者更长(中位PFI 12.9 vs 4.6个月；p & lt;0.001)。铂与lenvatinib/pembrolizumab的ORR分别为58%和49% （p = 0.27）。对于所有患者，PFI≤12个月和≤12个月的ORR分别为68%和47% （p = 0.002）。在每个PFI中，无论使用铂或lenvatinib/pembrolizumab治疗，ORR相似(PFI≤12个月ORR分别为49%和44%，p = 0.75；PFI >；12个月ORR分别为67%和75%，p = 0.74)。结论延长PFI可提高复发性子宫内膜癌患者对二线治疗的反应。尽管使用PFI作为现实世界的治疗决策，但没有发现在任何给定的PFI下预测方案之间的反应。

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Platinum-free interval and response to platinum retreatment or lenvatinib/pembrolizumab in patients with recurrent endometrial cancer: A real-world endometrial cancer molecularly targeted therapy consortium cohort study

Objective

We sought to determine the association between platinum-free interval (PFI) and response to retreatment with platinum-based chemotherapy vs lenvatinib/pembrolizumab in patients with recurrent endometrial cancer.

Methods

Endometrial Cancer Molecularly Targeted Therapy (ECMT2) Consortium patients with recurrent disease were included in this retrospective analysis if they received first-line treatment with platinum-based chemotherapy (adjuvant or first recurrence), followed by second-line re-treatment with platinum or lenvatinib/pembrolizumab. PFI was defined as time between date of last platinum to start date of second-line therapy. Patients were stratified according to PFI ≤12 months or > 12 months. Overall response rate (ORR) to second-line treatment was estimated after stratification by PFI.

Results

Of 217 patients, 146 (67 %) underwent retreatment with platinum and 71 (33 %) were treated with lenvatinib/pembrolizumab. 127 (59 %) had PFI ≤12 months, and 84 (39 %) patients had PFI >12 months. Patients treated with platinum had longer PFI than those treated with lenvatinib/pembrolizumab (median PFI 12.9 vs 4.6 months; p < 0.001). ORR was 58 % vs 49 % for platinum vs lenvatinib/pembrolizumab (p = 0.27). For all patients, ORR was 68 % vs 47 % with PFI >12 months and ≤ 12 months, respectively (p = 0.002). At each PFI, ORR was similar regardless of treatment with platinum or lenvatinib/pembrolizumab (PFI ≤12 months ORR 49 % vs 44 % respectively, p = 0.75; PFI >12 months ORR 67 % vs 75 % respectively, p = 0.74).

Conclusion

Longer PFI is associated with improved response to second-line treatment in patients with recurrent endometrial cancer. Despite utilization of PFI for real-world treatment decisions, it was not found to predict response between regimens at any given PFI.

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来源期刊

Gynecologic oncology 医学-妇产科学

CiteScore

8.60

自引率

6.40%

发文量

1062

审稿时长

37 days

期刊介绍： Gynecologic Oncology, an international journal, is devoted to the publication of clinical and investigative articles that concern tumors of the female reproductive tract. Investigations relating to the etiology, diagnosis, and treatment of female cancers, as well as research from any of the disciplines related to this field of interest, are published. Research Areas Include: • Cell and molecular biology • Chemotherapy • Cytology • Endocrinology • Epidemiology • Genetics • Gynecologic surgery • Immunology • Pathology • Radiotherapy