研究派姆单抗与化疗在胃癌和胃食管结癌中的协同作用。

IF 3.8 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Jun Okui, Kengo Nagashima, Satoru Matsuda, Yasunori Sato, Hirofumi Kawakubo, Masashi Takeuchi, Kenro Hirata, Kai Tsugaru, Shun Yamamoto, Motoo Nomura, Takahiro Tsushima, Hiroya Takeuchi, Ken Kato, Yuko Kitagawa
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引用次数: 0

摘要

目的:尽管免疫检查点抑制剂(ICIs)和化疗组合已被批准用于治疗胃和胃食管结癌(GC/GEJC),但免疫化疗(ICT)是否比简单添加单个单药治疗更有优势尚不清楚。本研究旨在探讨ICT对晚期GC/GEJC患者是否具有协同作用。材料和方法:从3个比较派姆单抗(KEYNOTE-061、KEYNOTE-062和KEYNOTE-859)的随机对照试验的Kaplan-Meier曲线中电子提取重建的个体患者数据。观察到的每一种单药治疗的无进展生存(PFS)曲线被用来估计在独立药物作用模型下预期的模拟PFS曲线。如果观察曲线显示PFS明显优于模拟曲线,则确定ICI和化疗联合具有协同效应,这意味着与添加成分的单一治疗相比,结果更好。结果:程序性细胞死亡配体1合并阳性评分≥1的患者(n= 2194),观察曲线和模拟曲线的1年和中位PFS分别为28.0%和27.9%,6.89个月和6.88个月。单样本log-rank检验显示,观察曲线与模拟曲线之间无显著差异(P=0.107)。结论:ICT观察到的PFS与基于每种单药治疗数据的预测PFS相当。我们的研究结果并没有提供直接的协同效应的证据,但它们表明联合ICI和化疗并不影响疗效。这些结果可能支持ICT在晚期GC/GEJC患者中的持续临床应用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Investigating the Synergistic Effects of Pembrolizumab and Chemotherapy in Gastric and Gastroesophageal Junction Cancer.

Investigating the Synergistic Effects of Pembrolizumab and Chemotherapy in Gastric and Gastroesophageal Junction Cancer.

Investigating the Synergistic Effects of Pembrolizumab and Chemotherapy in Gastric and Gastroesophageal Junction Cancer.

Investigating the Synergistic Effects of Pembrolizumab and Chemotherapy in Gastric and Gastroesophageal Junction Cancer.

Purpose: Although immune checkpoint inhibitors (ICIs) and chemotherapy combinations have been approved for the treatment of gastric and gastroesophageal junction cancer (GC/GEJC), whether immunochemotherapy (ICT) offers advantages over the simple addition of individual monotherapies remains unclear. This study aimed to investigate whether ICT has a synergistic effect in patients with advanced GC/GEJC.

Materials and methods: Reconstructed individual patient data were electronically extracted from the Kaplan-Meier curves of 3 randomized controlled trials comparing pembrolizumab (KEYNOTE-061, KEYNOTE-062, and KEYNOTE-859). The observed progression-free survival (PFS) curve for each monotherapy was used to estimate the simulated PFS curve expected under an independent drug action model. If the observed curve demonstrated significantly better PFS than the simulated curve, combined ICI and chemotherapy was determined to have a synergistic effect, implying a superior outcome compared to adding-component monotherapy.

Results: In patients with programmed cell death ligand 1 combined positive scores of ≥1 (n=2,194), the 1-year and median PFS of the observed and simulated curves were 28.0% vs. 27.9% and 6.89 months vs. 6.88 months, respectively. The one-sample log-rank test revealed no significant differences between the observed and simulated curves (P=0.107).

Conclusions: The observed PFS with ICT was comparable to the predicted PFS based on the data for each monotherapy. Our findings do not provide direct evidence of synergistic effects, but they suggest that combining ICI and chemotherapy does not compromise efficacy. These results may support the continued clinical use of ICT in patients with advanced GC/GEJC.

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来源期刊
Journal of Gastric Cancer
Journal of Gastric Cancer Biochemistry, Genetics and Molecular Biology-Cancer Research
CiteScore
4.30
自引率
12.00%
发文量
36
期刊介绍: The Journal of Gastric Cancer (J Gastric Cancer) is an international peer-reviewed journal. Each issue carries high quality clinical and translational researches on gastric neoplasms. Editorial Board of J Gastric Cancer publishes original articles on pathophysiology, molecular oncology, diagnosis, treatment, and prevention of gastric cancer as well as articles on dietary control and improving the quality of life for gastric cancer patients. J Gastric Cancer includes case reports, review articles, how I do it articles, editorials, and letters to the editor.
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