NEJM:Atezolizumab一线治疗转移性非鳞状非小细胞肺癌

2018-06-05 zhangfan MedSci原创

研究发现,Atezolizumab、贝伐单抗联合化疗可显著延长转移性非鳞状非小细胞肺癌患者无进展生存期以及总生存期,该效果不受PD-L1表达、EGFR以及ALK等基因突变的影响

贝伐单抗可通过阻断血管内皮生长因子,提高PD-1单抗Atezolizumab的肿瘤抑制效果。近日研究人员开展III期临床研究考察Atezolizumab+贝伐单抗+化疗对先前未经治疗的转移性非鳞状非小细胞肺癌(NSCLC)患者的疗效。

患者随机接受Atezolizumab+卡波铂+紫杉醇(ACP)、贝伐单抗+卡波铂+紫杉醇(BCP)或Atezolizumab+BCP(ABCP)治疗,每3周1次,持续4-6轮,之后接受Atezolizumab和或贝伐单抗维持治疗。研究的主要终点为野生型患者(无EGFR及ALK突变患者)以及效应T细胞(Teff)基因信号高表达的野生型患者的无进展生存期和总生存期。

野生型患者中,ABCP组356人,BCP组336人,ABCP组平均无进展生存期高于BCP组(8.3个月vs 6.8个月,进展或死亡风险为0.62)。对于效应T细胞(Teff)基因信号高表达的野生型患者,ABCP组以及BCP组无进展生存期分别为11.3个月和6.8个月。对于所有参与者(包括EGFR、ALK突变患者,PD-L1表达低及阴性人群,低Teff基因的表达或肝转移患者),ABCP治疗可显著延长无进展生存期。野生型亚组中,患者接受ABCP治疗后总生存期延长(19.2个月vs 14.7个月,死亡风险为0.78)。ABCP治疗的不良事件与先前各个单药一致。

研究发现,Atezolizumab、贝伐单抗联合化疗可显著延长转移性非鳞状非小细胞肺癌患者无进展生存期以及总生存期,该效果不受PD-L1表达、EGFR以及ALK等基因突变的影响。

原始出处:

Mark A. Socinski et al. Atezolizumab for First-Line Treatment of Metastatic Nonsquamous NSCLC. N Engl J Med.June 4 2018.

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    2019-02-15 snf701207
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    2018-06-08 1381ecb2e2m

    这得多贵啊!拼命攒钱吧!

    0

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