Lancet Oncol:纳武单抗新辅助免疫化疗大大改善可切除非小细胞肺癌的预后

2020-09-27 Q MedSci原创

大多数非小细胞肺癌(NSCLC)患者确诊时已是终末期,即局部晚期。本研究旨在评估新辅助化学免疫疗法对可切除的IIIA期NSCLC患者的抗肿瘤活性和安全性。

大多数非小细胞肺癌(NSCLC)患者确诊时已是终末期,即局部晚期。本研究旨在评估新辅助化学免疫疗法对可切除的IIIA期NSCLC患者的抗肿瘤活性和安全性。

该试验是一个在18家医院开展的开放标签、单臂的2期试验,招募年满18岁的组织学确诊的既往未治疗过的可手术切除的IIIA NSCLC患者,在术前予以3个疗程的新辅助治疗:紫杉醇(200 mg/m2)、卡铂(6 mg/mL·min)和纳武单抗(360 mg),第1天给药,1疗程/21天;术后予以纳武单抗单药维持治疗1年。主要终点是24个月时的无进展存活期。

2017年4月26日-2018年8月25日,筛查了51位患者,纳入了其中46位,予以新辅助治疗。

截止2020年1月31日,中位随访了24个月(IQR 21.4-28.1),41位肿瘤切除的患者中有35位无进展。24个月时,无进展存活率为77.1%(95% CI 59.9-87.7)。43位(93%)患者在新辅助治疗期间发生过治疗相关的不良反应,其中14人的治疗相关不良反应在3级及以上;但无一例不良反应与手术延迟或死亡相关。最常见的3级及以上治疗不良反应有脂肪酶升高(3例[7%])和发热性中性粒细胞减少(3例[7%])。

综上,该研究支持可切除的IIIA期NSCLC患者在铂类化疗中添加新辅助药物纳武单抗。新辅助化学免疫疗法有望将局部晚期肺癌从可能致命的疾病改变为可以治愈疾病。

原始出处:

Mariano Provencio, et al. Neoadjuvant chemotherapy and nivolumab in resectable non-small-cell lung cancer (NADIM): an open-label, multicentre, single-arm, phase 2 trial. The Lancet Oncology. September 24, 2020.

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    2020-12-08 minlingfeng
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    2020-12-01 howi
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createdTime=Sun Oct 11 08:37:27 CST 2020, time=2020-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=888881, encodeId=fd64888881e7, content=不知道现在IV期的临床治愈的机会大吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ed6d5422392, createdName=ms7000000891845564, createdTime=Mon Sep 28 11:58:19 CST 2020, time=2020-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=890774, encodeId=7362890e74c4, content=好文章,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJlfgys76DEiaNtbYo2re3ibjrUPTRibEXRyFwAB4aAGiave842S0FQDf0wAoaH226NiaSoPPDzhndsf1g/132, createdBy=88b489038, createdName=yangchou, 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  5. 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createdTime=Sun Oct 11 08:37:27 CST 2020, time=2020-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=888881, encodeId=fd64888881e7, content=不知道现在IV期的临床治愈的机会大吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ed6d5422392, createdName=ms7000000891845564, createdTime=Mon Sep 28 11:58:19 CST 2020, time=2020-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=890774, encodeId=7362890e74c4, content=好文章,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJlfgys76DEiaNtbYo2re3ibjrUPTRibEXRyFwAB4aAGiave842S0FQDf0wAoaH226NiaSoPPDzhndsf1g/132, createdBy=88b489038, createdName=yangchou, 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topicName=单抗)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200529/3611e9bb629c4e5b81fbd8ce784b06cc/128487eae357460bb98f67d86230c218.jpg, createdBy=ab235268530, createdName=神盾医疗局局长Jack, createdTime=Mon Sep 28 13:16:19 CST 2020, time=2020-09-28, status=1, ipAttribution=)]
    2020-10-14 148c91acm49暂无昵称

    学习了

    0

  6. 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createdTime=Sun Oct 11 08:37:27 CST 2020, time=2020-10-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=888881, encodeId=fd64888881e7, content=不知道现在IV期的临床治愈的机会大吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ed6d5422392, createdName=ms7000000891845564, createdTime=Mon Sep 28 11:58:19 CST 2020, time=2020-09-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=890774, encodeId=7362890e74c4, content=好文章,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTJlfgys76DEiaNtbYo2re3ibjrUPTRibEXRyFwAB4aAGiave842S0FQDf0wAoaH226NiaSoPPDzhndsf1g/132, createdBy=88b489038, createdName=yangchou, 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topicName=单抗)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200529/3611e9bb629c4e5b81fbd8ce784b06cc/128487eae357460bb98f67d86230c218.jpg, createdBy=ab235268530, createdName=神盾医疗局局长Jack, createdTime=Mon Sep 28 13:16:19 CST 2020, time=2020-09-28, status=1, ipAttribution=)]
    2020-10-11 子沐

    搞出一篇文章真的很难

    0

  7. 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topicName=单抗)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200529/3611e9bb629c4e5b81fbd8ce784b06cc/128487eae357460bb98f67d86230c218.jpg, createdBy=ab235268530, createdName=神盾医疗局局长Jack, createdTime=Mon Sep 28 13:16:19 CST 2020, time=2020-09-28, status=1, ipAttribution=)]
    2020-09-28 ms7000000891845564

    不知道现在IV期的临床治愈的机会大吗?

    0

  8. 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topicName=单抗)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200529/3611e9bb629c4e5b81fbd8ce784b06cc/128487eae357460bb98f67d86230c218.jpg, createdBy=ab235268530, createdName=神盾医疗局局长Jack, createdTime=Mon Sep 28 13:16:19 CST 2020, time=2020-09-28, status=1, ipAttribution=)]
    2020-10-09 yangchou

    好文章,谢谢分享

    0

  9. 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topicName=单抗)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200529/3611e9bb629c4e5b81fbd8ce784b06cc/128487eae357460bb98f67d86230c218.jpg, createdBy=ab235268530, createdName=神盾医疗局局长Jack, createdTime=Mon Sep 28 13:16:19 CST 2020, time=2020-09-28, status=1, ipAttribution=)]
    2020-09-30 yangchou

    肺癌治疗的新方法

    0

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    2020-09-28 神盾医疗局局长Jack

    #单抗#亟待进一步研究安全性问题

    0

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