Lancet:推荐将nivolumab联合伊匹单抗作为无症状未治疗过的黑色素瘤脑转移患者的一线疗法

2018-03-28 MedSci MedSci原创

对于转移性黑色素瘤患者,与ipilimumab(伊匹单抗)治疗相比,nivolumab单一疗法和nivolumab联合伊匹单抗均可提高缓解患者比例;但是,其用于治疗活动性脑转移患者的效果尚不明确。近日,Lancet子刊发表一篇文献,评估了nivolumab单独或联合伊匹单抗用于活动性黑色素瘤脑转移患者的疗效和安全性。研究人员在澳大利亚的四个地点开展一多中心的、开放性随机II期试验,招募年满18岁的

对于转移性黑色素瘤患者,与ipilimumab(伊匹单抗)治疗相比,nivolumab单一疗法和nivolumab联合伊匹单抗均可提高缓解患者比例;但是,其用于治疗活动性脑转移患者的效果尚不明确。近日,Lancet子刊发表一篇文献,评估了nivolumab单独或联合伊匹单抗用于活动性黑色素瘤脑转移患者的疗效和安全性。

研究人员在澳大利亚的四个地点开展一多中心的、开放性随机II期试验,招募年满18岁的未进行过免疫治疗的黑色素瘤脑转移患者,将既往未进行过局部脑治疗的无症状性脑转移患者按30:24随机分至A队列(nivolumab联合伊匹单抗)或B队列(nivolumab)。局部治疗失败的脑转移患者或有神经性症状或软脑膜疾病的患者全部纳入C队列(nivolumab)。A队列:nivolumab 1mg/kg 静脉+伊匹单抗 3mg/kg,1次/3周,持续4次,然后nivolumab 3mg/kg 1次/2周;B队列和C队列:nivolumab 3mg/kg 1次/2周。主要结点:12周后颅内缓解情况。

2014年11月4日-2017年4月21日,共招募79位患者(A队列36位、B队列27位、C队列16位)。A队列的1位患者和B队列的2位患者随后被发现不符合要求,于开始进行研究药物治疗前排除研究。截至2017年8月28日,中位随访17个月(IQR 8-25),A、B、C三个队列分别有7位(46%;95% CI 29-63)、5位(20%;7-41)和1位(6%;0-30)患者获得颅内缓解,而获得颅内完全缓解的分别有6位(17%)、3位(12%)和0位。A、B、C三个队列分别发生34例(97%)、17例(68%)和8例(50%)治疗相关的副反应。三个队列中3或4级治疗相关副反应分别出现19例(54%)、4例(16%)和2例(13%)。无治疗相关死亡。

Nivolumab联合伊匹单抗和nivolumab单药治疗黑色素瘤脑转移均可获得一定程度的缓解。联合治疗的患者获得颅内缓解的比例高。总而言之,应该考虑将nivolumab联合伊匹单抗这一疗法作为无症状未治疗过的脑转移瘤患者的一线疗法。

原始出处:

Georgina V Long,et al.Combination nivolumab and ipilimumab or nivolumab alone in melanoma brain metastases: a multicentre randomised phase 2 study.The Lancet Oncology. March 27,2018.https://doi.org/10.1016/S1470-2045(18)30139-6

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    2018-12-09 tamgche
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    2018-05-06 howi
  4. [GetPortalCommentsPageByObjectIdResponse(id=2007893, encodeId=0aad200e89343, content=<a href='/topic/show?id=601512826f6' target=_blank style='color:#2F92EE;'>#NIV#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12826, encryptionId=601512826f6, topicName=NIV)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=674961, createdName=tamgche, createdTime=Sun Dec 09 22:49:00 CST 2018, time=2018-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1810478, encodeId=69c518104e84d, content=<a href='/topic/show?id=e3258513293' target=_blank style='color:#2F92EE;'>#脑转移患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85132, encryptionId=e3258513293, topicName=脑转移患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Sat Jul 07 12:49:00 CST 2018, time=2018-07-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1829559, encodeId=72f318295594a, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sun May 06 12:49:00 CST 2018, time=2018-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1680512, encodeId=dcc616805124e, content=<a href='/topic/show?id=9e5c86e0712' target=_blank style='color:#2F92EE;'>#色素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86707, 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channel=null, level=null, likeNumber=15, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59027, encryptionId=4bbe5902ed2, topicName=无症状)], attachment=null, authenticateStatus=null, createdAvatar=Bioon/avatar/20180429/70baad2aa5a046c5aa2914d262de7d37.jpg, createdBy=bd077990475, createdName=12498da4m34(暂无昵称), createdTime=Fri Mar 30 07:49:00 CST 2018, time=2018-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1558889, encodeId=c7141558889fa, content=<a href='/topic/show?id=e27610332666' target=_blank style='color:#2F92EE;'>#黑色素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=16, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103326, encryptionId=e27610332666, topicName=黑色素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=150614999302, createdName=cqlidoudou, createdTime=Fri Mar 30 07:49:00 CST 2018, time=2018-03-30, status=1, ipAttribution=), 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GetPortalCommentsPageByObjectIdResponse(id=300557, encodeId=722230055e4e, content=谢谢学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Wed Mar 28 21:11:33 CST 2018, time=2018-03-28, status=1, ipAttribution=)]
    2018-04-06 sunylz
  5. [GetPortalCommentsPageByObjectIdResponse(id=2007893, encodeId=0aad200e89343, content=<a href='/topic/show?id=601512826f6' target=_blank style='color:#2F92EE;'>#NIV#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12826, encryptionId=601512826f6, topicName=NIV)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=674961, createdName=tamgche, createdTime=Sun Dec 09 22:49:00 CST 2018, time=2018-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1810478, encodeId=69c518104e84d, content=<a href='/topic/show?id=e3258513293' target=_blank style='color:#2F92EE;'>#脑转移患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85132, encryptionId=e3258513293, topicName=脑转移患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智慧医人, createdTime=Sat Jul 07 12:49:00 CST 2018, time=2018-07-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1829559, encodeId=72f318295594a, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Sun May 06 12:49:00 CST 2018, time=2018-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1680512, encodeId=dcc616805124e, content=<a href='/topic/show?id=9e5c86e0712' target=_blank style='color:#2F92EE;'>#色素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=86707, 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channel=null, level=null, likeNumber=15, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59027, encryptionId=4bbe5902ed2, topicName=无症状)], attachment=null, authenticateStatus=null, createdAvatar=Bioon/avatar/20180429/70baad2aa5a046c5aa2914d262de7d37.jpg, createdBy=bd077990475, createdName=12498da4m34(暂无昵称), createdTime=Fri Mar 30 07:49:00 CST 2018, time=2018-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1558889, encodeId=c7141558889fa, content=<a href='/topic/show?id=e27610332666' target=_blank style='color:#2F92EE;'>#黑色素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=16, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103326, encryptionId=e27610332666, topicName=黑色素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=150614999302, createdName=cqlidoudou, createdTime=Fri Mar 30 07:49:00 CST 2018, time=2018-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1564898, encodeId=ce92156489884, content=<a href='/topic/show?id=e27610332666' target=_blank style='color:#2F92EE;'>#黑色素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103326, encryptionId=e27610332666, topicName=黑色素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=150614999302, createdName=cqlidoudou, createdTime=Fri Mar 30 07:49:00 CST 2018, time=2018-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=300752, encodeId=da6f300e52cd, content=不错耶.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Thu Mar 29 07:06:28 CST 2018, time=2018-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=300557, encodeId=722230055e4e, content=谢谢学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Wed Mar 28 21:11:33 CST 2018, time=2018-03-28, status=1, ipAttribution=)]
    2018-06-19 snf701207
  6. [GetPortalCommentsPageByObjectIdResponse(id=2007893, encodeId=0aad200e89343, content=<a href='/topic/show?id=601512826f6' target=_blank style='color:#2F92EE;'>#NIV#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12826, encryptionId=601512826f6, topicName=NIV)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=674961, createdName=tamgche, createdTime=Sun Dec 09 22:49:00 CST 2018, time=2018-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1810478, encodeId=69c518104e84d, content=<a href='/topic/show?id=e3258513293' target=_blank style='color:#2F92EE;'>#脑转移患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85132, encryptionId=e3258513293, topicName=脑转移患者)], attachment=null, authenticateStatus=null, createdAvatar=, 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channel=null, level=null, likeNumber=15, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59027, encryptionId=4bbe5902ed2, topicName=无症状)], attachment=null, authenticateStatus=null, createdAvatar=Bioon/avatar/20180429/70baad2aa5a046c5aa2914d262de7d37.jpg, createdBy=bd077990475, createdName=12498da4m34(暂无昵称), createdTime=Fri Mar 30 07:49:00 CST 2018, time=2018-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1558889, encodeId=c7141558889fa, content=<a href='/topic/show?id=e27610332666' target=_blank style='color:#2F92EE;'>#黑色素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=16, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103326, encryptionId=e27610332666, topicName=黑色素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=150614999302, createdName=cqlidoudou, createdTime=Fri Mar 30 07:49:00 CST 2018, time=2018-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1564898, encodeId=ce92156489884, content=<a href='/topic/show?id=e27610332666' target=_blank style='color:#2F92EE;'>#黑色素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103326, encryptionId=e27610332666, topicName=黑色素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=150614999302, createdName=cqlidoudou, createdTime=Fri Mar 30 07:49:00 CST 2018, time=2018-03-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=300752, encodeId=da6f300e52cd, content=不错耶.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Thu Mar 29 07:06:28 CST 2018, time=2018-03-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=300557, encodeId=722230055e4e, content=谢谢学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Wed Mar 28 21:11:33 CST 2018, time=2018-03-28, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=2007893, encodeId=0aad200e89343, content=<a href='/topic/show?id=601512826f6' target=_blank style='color:#2F92EE;'>#NIV#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12826, encryptionId=601512826f6, topicName=NIV)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=674961, createdName=tamgche, createdTime=Sun Dec 09 22:49:00 CST 2018, time=2018-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1810478, encodeId=69c518104e84d, content=<a href='/topic/show?id=e3258513293' target=_blank style='color:#2F92EE;'>#脑转移患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85132, encryptionId=e3258513293, topicName=脑转移患者)], attachment=null, authenticateStatus=null, createdAvatar=, 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  8. 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  9. 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    2018-03-29 owlhealth

    不错耶.学习了

    0

  10. 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GetPortalCommentsPageByObjectIdResponse(id=300557, encodeId=722230055e4e, content=谢谢学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Wed Mar 28 21:11:33 CST 2018, time=2018-03-28, status=1, ipAttribution=)]
    2018-03-28 changjiu

    谢谢学习一下

    0

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《分子细胞》杂志近期出了一项新研究,按说已经挺安全的硫酸软骨素,居然也是个要小心的对象!

Nat Commun:黑色素瘤耐药机制研究取得突破性进展

近日,西安交大生命学院线粒体生物医学研究所和前沿院转化医学研究中心等单位合作,发现了一种新的基于磷酸化与SUMO化修饰的SOX10转录活性调控机制,揭示了ERK1/2/SOX10/FOXD3/ERBB3信号通路在人黑色素瘤对RAF抑制剂的适应性耐药发生过程中的作用。这一突破性的进展将会极大地促进以SOX10为靶点提高黑色素瘤的治疗效果方面的研究。