盘点：JCO 杂志7月第1期精选文章一览

2017-07-24 xiangting MedSci原创

JCO杂志7月第一期精选文章一览

【1】雄激素受体剪接变异与前列腺癌抵抗阿比特龙和恩杂鲁胺的关联

doi: 10.1200/JCO.2017.72.8808 Journal of Clinical Oncology 35, no. 19 (July 2017) 2103-2105.

雄激素受体（AR）在前列腺癌（PC）中起重要作用。CYP17A1抑制剂阿比特龙和雄激素结合竞争性拮抗剂恩杂鲁胺可治疗部分去势抵抗性前列腺癌（CRPC）。Antonarakis等研究显示在阿比特龙或恩杂鲁胺抵抗性前列腺癌中，AR剪接变异体在驱动AR活性中起重要作用。这项研究纳入202例转移性CRPC患者，探讨了循环肿瘤细胞（CTCs），AR最常见的变异体AR-V7表达与CRCP患者阿比特龙或恩杂鲁胺治疗反应之间的关联。

【2】循环肿瘤细胞（CTCs）中雄激素受体剪接变异体-7（AR-V7）mRNA检测在阿比特龙和恩杂鲁胺治疗转移去势抵抗性前列腺癌（mCRPC）的临床意义

doi: 10.1200/JCO.2016.70.1961 Journal of Clinical Oncology 35, no. 19 (July 2017) 2149-2156.

Emmanuel S等报道通过前瞻性纳入202例使用阿比特龙和恩杂鲁胺治疗的CRCP患者，使用基于CTC的AR-V7mRNA检测法评估CTC检测和AR-V7检测的预后价值。表明基于CTC的AR-V7mRNA检测在预测接受一线和二线新型内分泌治疗的患者疗效的重要性，这项研究是第一个应用该检测方法建立三种独立的预后类别进行预后分析的研究：CTC-，CTC+/AR-V7-和CTC+/AR-V7+。

【3】抗Trop-2抗体偶联物Sacituzumab Govitecan（IMMU-132）在既往多线治疗的转移性三阴性乳腺癌中的疗效和安全性

doi: 10.1200/JCO.2016.70.8297 Journal of Clinical Oncology 35, no. 19 (July 2017) 2141-2148.

在大多数三阴性乳腺癌（TNBCs）中表达的Trop-2可能是抗体-药物偶联物的潜在靶点。Sacituzumab Govitecan作为抗体-药物偶联物，可以针对Trop-2选择性释放伊立替康的活性代谢产物SN-38。这项研究中在复发/难治性转移性TNBC患者中，评估了每21天重复治疗周期第1天和第8天接受10mg/kg起始剂量的Sacituzumab Govitecan。结果表明Sacituzumab Govitecan在既往多线治疗的转移性TNBC患者中耐受性号，可以达到早期及持久缓解。

【4】塞来昔布联合标准化疗治疗环氧化酶-2过度表达的晚期非小细胞肺癌III期临床试验

doi: 10.1200/JCO.2016.71.3743 Journal of Clinical Oncology 35, no. 19 (July 2017) 2184-2192.

环氧化酶-2（COX-2）过度表达和非小细胞肺癌(NSCLC)预后不良有关。此前研究表明选择性COX-2抑制剂塞来昔布联合化疗可以提高免疫组化（IHC）检测COX-2高表达的晚期NSCLC患者的无进展生存期和总生存期。这项研究旨在证明塞来昔布改善COX-2指数≥4患者的无进展生存期。结果证明IHC检测COX-2的表达无法筛选从选择性COX-2抑制剂获益的患者。尿液前列腺素E2的代谢产物或许可以做到这一点。

【5】索拉菲尼在丙肝阴性的肝癌患者中的应用：无需因噎废食

doi: 10.1200/JCO.2017.72.7776 Journal of Clinical Oncology 35, no. 19 (July 2017) 2213-2214.

目前索拉菲尼是一线治疗晚期不可切除肝细胞肝癌（HCC）的唯一获批药物。这篇文章通过对几个已发表的关于索拉菲尼治疗丙肝阴性肝癌的荟萃分析的研究，表明索拉菲尼的治疗效果不限于HCV感染患者，目前索拉菲尼仍优于安慰剂，应列入所有HCC患者的治疗选择，无论其HBV和/或HCC感染状态如何。索拉菲尼在HCV相关HCC中效果更佳的机制还不清楚，确切回答索拉菲尼带来的生存获益是否限于特定病因学亚组人群，还有待未来针对病因学进行分层的随机临床研究。

【6】 Avelumab，抗程序性死亡配体1抗体，治疗难治性转移性尿路上皮癌患者：多中心，Ib期研究结果

doi：10.1200/JCO.2016.71.6795 Journal of Clinical Oncology 35, no. 19 (July 2017) 2117-2124.

Avelumab是一种人类抗程序性死亡配体1（PD-L1）IgG1抗体，Andrea B. Apolo等在难治性转移性尿路上皮癌患者中评估了其安全性和抗肿瘤活性。44例接受avelumab治疗的患者，中位随访时间16.5个月。最常见的治疗相关不良事件为疲劳/乏力（31.8％），输液相关反应（20.5％）和恶心（11.4％）。核查后确定的客观不良反应率为18.2％。8例反应患者中有7例患有PD-L1阳性肿瘤。中位无进展生存期为11.6周，中位总生存率为13.7个月，12个月总生存率为54.3％

。avelumab耐受性良好，与难治性转移性UC患者的耐久反应和生存期延长相关。

【7】Pembrolizumab治疗复发/难治性经典霍奇金淋巴瘤的疗效和安全性研究

doi：10.1200/JCO.2016.72.1316 Journal of Clinical Oncology 35, no. 19 (July 2017) 2125-2132.

霍奇金 Reed-Sternberg细胞在染色体9p24.1存在改变，导致程序性死亡配体1（PD-L1）和PD-L2的过表达。Pembrolizumab是程序性死亡1阻断抗体，在I期测试中证实在复发或难治性经典霍奇金淋巴瘤（rrHL）患者中有较高的总体反应率（ORR）。Robert Chen等报道在210例入组和治疗的患者中(队列1中69 例, 队列2中81例, 队列3中60例)，中位治疗时间为13个治疗周期。总体来说，ORR为69.0％，完全反应率为22.4％。不同队列中，队列1的ORR分别为73.9％，队列2为64.2％，队列3为70.0％.31例患者的反应≥6个月。安全性与以前的Pembrolizumab研究基本一致。Pembrolizumab与rrHL患者的高反应率和可接受的安全性相关，为该疾病提供了新的治疗方法。

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2018-04-20 lidong40

#JCO#

29 0
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2017-07-25 luominglian113

学习了，谢谢分享

55 0
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2017-07-24 虈亣靌

.内容很好，学习了

60 0
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2017-07-24 执着追梦

学习，谢谢分享

56 0
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2017-07-24 1e0f8808m18(暂无匿称)

好文章，学习了

56 0
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2017-07-24 KO229256262

很好，学习了，谢谢分享

55 0

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