Lancet oncol:派姆单抗可显著改善MSI-H或dMMR的转移性结直肠癌患者的生活质量

2021-04-03 Nebula MedSci原创

对于既往未治疗过的微卫星不稳定高或错配修复缺陷的转移性结直肠癌,派姆单抗单一疗法可相比化疗明显提高患者的健康相关生活质量

结直肠癌是全球第三常见的癌症和第二位的癌症死亡原因。在过去10年转移性结直肠癌的治疗策略迅速发展,极大提高了患者的存活率。但是,大部分患者仍不能治愈,治疗目的还是侧重与提高存活率、延缓肿瘤进展、控制症状和提高或维持健康相关生活质量(HRQOL)。

KEYNOTE-177试验是一项在23个国家的192个癌症中心开展的开放标签的随机3期试验,在年满18岁的微卫星不稳定高(MSI-H)或错配修复缺陷(dMMR)的既往未治疗过的转移性结直肠患者中对比了派姆单抗单一疗法和化疗作为一线治疗方案的疗效和安全性。

主要终点分析结果显示,与化疗相比,派姆单抗单一疗法作为晚期微卫星不稳定性高或错配修复缺陷的转移性结直肠癌的一线治疗,可显著延长患者的无进展存活期

为了进一步支持该试验的疗效和安全性结果,本文报告了对该试验患者的HRQOL的分析结果

在2016年2月11日-2018年2月19日期间,共有307位患者被随机分至派姆单抗组(n=153)或化疗组(n=154),其中294位(派姆单抗组 152人、化疗组 142人)被纳入了HRQOL分析。

EORTC QLQ-C30评分变化

截止2020年2月19日,随机分组后的中位随访时间为32.4个月。从基线到预定的第18周时的最小二乘均方(LSM)分析显示,与化疗组相比,派姆单抗组的EORTC QLQ-C30 GHS/QOL评分显著提高(组间LSM差异 8.96,p=0.0002)。在GHS/QOL、生理功能、社会功能和疲劳评分方面,派姆单抗组的恶化前中位时间均长于化疗组。

从基线到第18周时EORTC QLQ-C30评分的平均变化

综上,对于既往未治疗过的微卫星不稳定高或错配修复缺陷的转移性结直肠癌,派姆单抗单一疗法可相比化疗明显提高患者的HRQOL。这些分析结果,与既往报道的临床获益一致,都支持派姆单抗作为这类患者人群的一线治疗选择。

原始出处:

Thierry Andre, et al. Health-related quality of life in patients with microsatellite instability-high or mismatch repair deficient metastatic colorectal cancer treated with first-line pembrolizumab versus chemotherapy (KEYNOTE-177): an open-label, randomised, phase 3 trial. The Lancet Oncology. April 01, 2021.

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    2022-02-05 hb2008ye
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    2021-08-11 heli0118
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encodeId=aeea1025956bb, content=肿瘤免疫是大家关心的话题,K药与其它药对比,值得关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健康达人, createdTime=Sat Apr 03 17:59:06 CST 2021, time=2021-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034246, encodeId=eefa103424658, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Sat Apr 03 17:59:06 CST 2021, time=2021-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038244, encodeId=b33a103824499, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Sat Apr 03 17:59:06 CST 2021, time=2021-04-03, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1831093, encodeId=8c9b183109363, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Sat Feb 05 21:59:06 CST 2022, time=2022-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1866041, encodeId=d28a186604153, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=null, 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encryptionId=f08293399f9, topicName=转移性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ac22500003, createdName=1249842em09(暂无昵称), createdTime=Mon Apr 05 05:59:06 CST 2021, time=2021-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1453489, encodeId=4d0414534890b, content=<a href='/topic/show?id=098ee8679ad' target=_blank style='color:#2F92EE;'>#结直肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78679, encryptionId=098ee8679ad, topicName=结直肠)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=9ace5575596, createdName=crystal0564, createdTime=Mon Apr 05 05:59:06 CST 2021, time=2021-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1555897, encodeId=0ba8155589e5f, content=<a href='/topic/show?id=28c512040bb' target=_blank style='color:#2F92EE;'>#MMR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12040, encryptionId=28c512040bb, topicName=MMR)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dde614671787, createdName=vividelife, createdTime=Mon Apr 05 05:59:06 CST 2021, time=2021-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1581118, encodeId=07d11581118cb, content=<a href='/topic/show?id=a8ec122803c' target=_blank style='color:#2F92EE;'>#MSI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12280, encryptionId=a8ec122803c, topicName=MSI)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f65a16715482, createdName=小几洁, createdTime=Mon Apr 05 05:59:06 CST 2021, time=2021-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1025956, encodeId=aeea1025956bb, content=肿瘤免疫是大家关心的话题,K药与其它药对比,值得关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健康达人, createdTime=Sat Apr 03 17:59:06 CST 2021, time=2021-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034246, encodeId=eefa103424658, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Sat Apr 03 17:59:06 CST 2021, time=2021-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038244, encodeId=b33a103824499, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Sat Apr 03 17:59:06 CST 2021, time=2021-04-03, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1831093, encodeId=8c9b183109363, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Sat Feb 05 21:59:06 CST 2022, time=2022-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1866041, encodeId=d28a186604153, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=null, 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beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12040, encryptionId=28c512040bb, topicName=MMR)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dde614671787, createdName=vividelife, createdTime=Mon Apr 05 05:59:06 CST 2021, time=2021-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1581118, encodeId=07d11581118cb, content=<a href='/topic/show?id=a8ec122803c' target=_blank style='color:#2F92EE;'>#MSI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12280, encryptionId=a8ec122803c, topicName=MSI)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f65a16715482, createdName=小几洁, createdTime=Mon Apr 05 05:59:06 CST 2021, time=2021-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1025956, encodeId=aeea1025956bb, content=肿瘤免疫是大家关心的话题,K药与其它药对比,值得关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健康达人, createdTime=Sat Apr 03 17:59:06 CST 2021, time=2021-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034246, encodeId=eefa103424658, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Sat Apr 03 17:59:06 CST 2021, time=2021-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038244, encodeId=b33a103824499, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Sat Apr 03 17:59:06 CST 2021, time=2021-04-03, status=1, ipAttribution=)]
    2021-04-05 vividelife
  7. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12040, encryptionId=28c512040bb, topicName=MMR)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dde614671787, createdName=vividelife, createdTime=Mon Apr 05 05:59:06 CST 2021, time=2021-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1581118, encodeId=07d11581118cb, content=<a href='/topic/show?id=a8ec122803c' target=_blank style='color:#2F92EE;'>#MSI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12280, encryptionId=a8ec122803c, topicName=MSI)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f65a16715482, createdName=小几洁, createdTime=Mon Apr 05 05:59:06 CST 2021, time=2021-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1025956, 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Sat Apr 03 17:59:06 CST 2021, time=2021-04-03, status=1, ipAttribution=)]
    2021-04-05 小几洁
  8. [GetPortalCommentsPageByObjectIdResponse(id=1831093, encodeId=8c9b183109363, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Sat Feb 05 21:59:06 CST 2022, time=2022-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1866041, encodeId=d28a186604153, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=null, 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Sat Apr 03 17:59:06 CST 2021, time=2021-04-03, status=1, ipAttribution=)]
    2021-04-03 健康达人

    肿瘤免疫是大家关心的话题,K药与其它药对比,值得关注!

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1831093, encodeId=8c9b183109363, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Sat Feb 05 21:59:06 CST 2022, time=2022-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1866041, encodeId=d28a186604153, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=null, 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beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12040, encryptionId=28c512040bb, topicName=MMR)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=dde614671787, createdName=vividelife, createdTime=Mon Apr 05 05:59:06 CST 2021, time=2021-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1581118, encodeId=07d11581118cb, content=<a href='/topic/show?id=a8ec122803c' target=_blank style='color:#2F92EE;'>#MSI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12280, encryptionId=a8ec122803c, topicName=MSI)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f65a16715482, createdName=小几洁, createdTime=Mon Apr 05 05:59:06 CST 2021, time=2021-04-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1025956, encodeId=aeea1025956bb, content=肿瘤免疫是大家关心的话题,K药与其它药对比,值得关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健康达人, createdTime=Sat Apr 03 17:59:06 CST 2021, time=2021-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034246, encodeId=eefa103424658, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Sat Apr 03 17:59:06 CST 2021, time=2021-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038244, encodeId=b33a103824499, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Sat Apr 03 17:59:06 CST 2021, time=2021-04-03, status=1, ipAttribution=)]
    2021-04-03 goodbing

    顶刊就是不一样,质量很高,内容精彩!学到很多

    0

  10. 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encodeId=aeea1025956bb, content=肿瘤免疫是大家关心的话题,K药与其它药对比,值得关注!, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健康达人, createdTime=Sat Apr 03 17:59:06 CST 2021, time=2021-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1034246, encodeId=eefa103424658, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Sat Apr 03 17:59:06 CST 2021, time=2021-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038244, encodeId=b33a103824499, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Sat Apr 03 17:59:06 CST 2021, time=2021-04-03, status=1, ipAttribution=)]
    2021-04-03 anti-cancer

    谢谢梅斯分享这么多精彩信息

    0

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