与晚期肉瘤免疫检查点抑制剂应答相关的临床和生物学因素:IMPRESARC,一项法国回顾性多中心队列研究

IF 5.1 2区 医学 Q1 ONCOLOGY
Cancer Pub Date : 2025-09-05 DOI:10.1002/cncr.70052
Mina Fazel MD, Romain Varnier MD, Hélène Vanacker MD, PhD, Nicolas Penel MD, PhD, Sarah Watson MD, PhD, Benjamin Verret MD, Thibaud Valentin MD, Emmanuelle Bompas MD, Waisse Waissi MD, PhD, Alexandra Meurgey MD, Françoise Ducimetière PhD, Jean-Yves Blay MD, PhD, Armelle Dufresne MD, PhD, Mehdi Brahmi MD, PhD
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引用次数: 0

摘要

免疫检查点抑制剂(ICIs)在未选择的肉瘤中产生有限的反应率和肿瘤控制。然而,长期应答者的报道表明,通过确定可靠的应答预测因素来优化患者选择是一个关键的挑战。方法:作者对法国6个参考肉瘤中心接受ICIs治疗的晚期肉瘤患者进行了一项多中心、回顾性研究。该研究评估了疗效和安全性,以及与客观缓解率(ORR)、无进展生存期(PFS)和总生存期(OS)相关的临床和生物学变量。结果共纳入272例患者。ORR为17%,部分缓解为16%,完全缓解为1%。33%的患者出现稳定性疾病(SD),疾病控制率为49%。中位PFS为2.7个月(95%可信区间[CI], 2.5-3.4), 28%的患者PFS为6个月,13%的患者PFS为12个月。中位生存期为13.5个月(95% CI, 11.0-17.3)。安全性与临床试验一致,5%的患者出现≥3级不良事件,10%的患者因毒性而停止治疗。较差的预后与较高的东部肿瘤合作组表现状态(≥1)、环磷酰胺共给药和较高的衍生中性粒细胞与淋巴细胞比率相关。与抗pd -1相比,抗程序性死亡配体1 (PD-L1)治疗与更短的生存期相关。组织类型如肺泡软组织肉瘤(ASPS)生存率较高,而去分化脂肪肉瘤预后较差。结论:尽管中位PFS较短,但某些组织学亚型,包括ASPS、脊索瘤、smarca4缺陷肿瘤、胃肠道间质瘤和NF1突变,显示出强烈的活性信号,表明在一些患者中存在长期反应。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Clinical and biological factors associated with response to immune checkpoint inhibitors in advanced sarcomas: IMPRESARC, a French retrospective multicenter cohort study

Clinical and biological factors associated with response to immune checkpoint inhibitors in advanced sarcomas: IMPRESARC, a French retrospective multicenter cohort study

Clinical and biological factors associated with response to immune checkpoint inhibitors in advanced sarcomas: IMPRESARC, a French retrospective multicenter cohort study

Clinical and biological factors associated with response to immune checkpoint inhibitors in advanced sarcomas: IMPRESARC, a French retrospective multicenter cohort study

Clinical and biological factors associated with response to immune checkpoint inhibitors in advanced sarcomas: IMPRESARC, a French retrospective multicenter cohort study

Background

Immune checkpoint inhibitors (ICIs) in unselected sarcomas yield limited response rates and tumor control. Long-term responders have however been reported, suggesting a critical challenge in refining patient selection, by identifying reliable predictive factors for response.

Methods

The authors conducted a multicenter, retrospective study of patients with advanced sarcomas treated with ICIs in six French reference sarcoma centers. The study assessed efficacy and safety, as well as clinical and biological variables associated with objective response rate (ORR), progression-free survival (PFS), and overall survival (OS).

Results

A total of 272 patients were included in the analysis. The ORR was 17%, with 16% partial responses and 1% complete responses. Stable disease (SD) occurred in 33% of patients, resulting in a disease control rate of 49%. Median PFS was 2.7 months (95% confidence interval [CI], 2.5–3.4), with 28% of patients showing PFS >6 months and 13% with PFS >12 months. Median OS was 13.5 months (95% CI, 11.0–17.3). The safety profile was consistent with that of clinical trials, with 5% of patients experiencing grade ≥3 adverse events and 10% discontinuing treatment due to toxicity. Poorer outcomes were associated with high Eastern Cooperative Oncology Group performance status (≥1), cyclophosphamide coadministration, and high derived neutrophil-to-lymphocyte ratio. Anti-programmed death-ligand 1 (PD-L1) therapies were associated with shorter OS compared to anti–PD-1. Histotypes such as alveolar soft part sarcoma (ASPS) had better survival, whereas dedifferentiated liposarcoma had poorer outcomes.

Conclusions

Despite a short median PFS, certain histological subtypes, including ASPS, chordomas, SMARCA4-deficient tumors, gastro-intestinal stromal tumor, and NF1 mutations, showed strong activity signals, indicating long-term responses in some patients.

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来源期刊
Cancer
Cancer 医学-肿瘤学
CiteScore
13.10
自引率
3.20%
发文量
480
审稿时长
2-3 weeks
期刊介绍: The CANCER site is a full-text, electronic implementation of CANCER, an Interdisciplinary International Journal of the American Cancer Society, and CANCER CYTOPATHOLOGY, a Journal of the American Cancer Society. CANCER publishes interdisciplinary oncologic information according to, but not limited to, the following disease sites and disciplines: blood/bone marrow; breast disease; endocrine disorders; epidemiology; gastrointestinal tract; genitourinary disease; gynecologic oncology; head and neck disease; hepatobiliary tract; integrated medicine; lung disease; medical oncology; neuro-oncology; pathology radiation oncology; translational research
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