顽固性四期肺癌中PEF治疗的早期经验

IF 4.5 2区医学 Q1 ONCOLOGY

Lung Cancer Pub Date : 2025-05-10 DOI:10.1016/j.lungcan.2025.108575

William H. Moore , Mikhail Silk , Priya Bhattacharji , Bradley B. Pua , Joseph Mammarappallil , Daniel H. Sterman , Abraham Chachoua

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引用次数: 0

摘要

随着分子靶向治疗、免疫治疗和联合一线治疗的引入，晚期非小细胞肺癌的治疗也在不断发展。尽管取得了这些进展，但大多数患者经历了治疗失败，导致预后不良，其特征是中位无进展生存期（PFS）和总生存期（OS）较低。与最佳支持治疗相比，二线化疗已显示出最低限度的生存率改善。探索新的机制来提高这一患者群体的治疗反应是至关重要的。目的：本回顾性研究旨在评估与倾向匹配队列相比，先前接受脉冲电场（PEF）全身治疗失败的IV期肺癌患者队列是否有生存获益。方法回顾性分析2023年1月1日至2024年7月1日在三家学术机构接受PEF治疗的41例进展期非小细胞肺癌患者。肿瘤反应按照RECIST 1.1标准进行评估。一个倾向匹配队列的50例晚期NSCLC患者接受了全身治疗。进行统计分析，包括Kaplan-Meier生存估计和风险比。结果pef治疗组1年PFS为63.2%，OS为74.3%。相比之下，匹配队列显示1年PFS为11.8%，OS为33%。PEF组PFS的风险比为3.66 (p <；0.0001)， OS为3.5 (p = 0.0007)，表明接受PEF的患者具有显著的生存优势。结论本研究提示，与匹配队列相比，进行性IV期非小细胞肺癌患者的PFS和OS可能与PEF治疗显著改善相关。需要前瞻性对照研究来证实这些初步发现，以更好地了解PEF的作用机制，并确定哪些患者群体最能从这种治疗中受益。

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Early experience with PEF in the setting of recalcitrant stage IV lung cancer

Background

Advanced-stage non-small cell lung cancer treatment has evolved with the introduction of molecularly targeted therapy, immunotherapy and combination frontline therapies. Despite these advancements, most patients experience treatment failure, resulting in poor prognosis characterized by low median progression-free survival (PFS) and overall survival (OS). Second-line chemotherapy has demonstrated minimally improved survival compared to best supportive care. Exploring new mechanisms to enhance treatment response in this patient population is critical.

Objective

This retrospective study aims to assess if there is survival benefit in a cohort of patients with stage IV lung cancer who have failed previous systemic therapy treated with pulsed electrical fields (PEF) therapy compared to a propensity-matched cohort.

Methods

A retrospective review of patients treated with PEF at three academic institutions from January 1, 2023, to July 1, 2024, yielded 41 patients with progressive stage IV non-small cell lung cancer. Tumor response was evaluated by RECIST 1.1 criteria. A propensity matched cohort of 50 patients with advanced NSCLC undergoing systemic therapy was identified. Statistical analyses, including Kaplan-Meier survival estimates and Hazard ratios, were conducted.

Results

The PEF-treated cohort exhibited a 1-year PFS of 63.2 % and OS of 74.3 %. In contrast, the matched cohort demonstrated a 1-year PFS of 11.8 % and OS of 33 %. The hazard ratio for PFS in the PEF group was 3.66 (p < 0.0001) and for OS was 3.5 (p = 0.0007), indicating a significant survival advantage for patients receiving PEF.

Conclusion

This study suggests that PEF therapy may be associated with significantly improved PFS and OS in patients with progressive stage IV non-small cell lung cancer compared to the matched cohort. Prospective controlled studies are required to confirm these preliminary findings, to better understand the mechanism of action of PEF, and to identify which patient populations would best benefit from this therapy.

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来源期刊

Lung Cancer 医学-呼吸系统

CiteScore

9.40

自引率

3.80%

发文量

407

审稿时长

25 days

期刊介绍： Lung Cancer is an international publication covering the clinical, translational and basic science of malignancies of the lung and chest region.Original research articles, early reports, review articles, editorials and correspondence covering the prevention, epidemiology and etiology, basic biology, pathology, clinical assessment, surgery, chemotherapy, radiotherapy, combined treatment modalities, other treatment modalities and outcomes of lung cancer are welcome.