AACR 2020:免疫联合治疗在三阴性乳腺癌治疗中获突破,OS高达16个月

2020-04-29 MedSci MedSci原创

涉及转移的三阴性乳腺癌目前的主要治疗方法仍是化疗,在美国还没有靶向药物上市,而该类型癌症在获得诊断后通常只有20个月的生存期。三阴性乳腺癌具有侵略性的本质以及在病理学和分子水平的异质性决定了该种癌症的

涉及转移的三阴性乳腺癌目前的主要治疗方法仍是化疗,在美国还没有靶向药物上市,而该类型癌症在获得诊断后通常只有20个月的生存期。三阴性乳腺癌具有侵略性的本质以及在病理学和分子水平的异质性决定了该种癌症的较差的预后。该类乳腺癌中,雌激素受体、孕激素受体及表皮生长因子受体Her2均为阴性,患者对目前治疗药物应答表现不一。

然而,已有大量研究证明了三阴性乳腺癌的高免疫原性,这为肿瘤免疫疗法的介入提供了理论依据。三阴性乳腺癌中与肿瘤细胞的淋巴浸润具有直接关系的PD-L1高水平表达发生的频率很高,这为免疫检查点抑制剂的针对性治疗提供了可能。

不过,既往的多项研究已经证实单药使用疗效是很一般的,比如在keynote086研究中,整体的后线有效率为5.3%。因此,乳癌的免疫研究更多倾向于联合方向。

在此次AACR大会上,公布了一项IMPRIME 1研究,采用了免疫激动剂PGG联合Keytruda 进行三阴乳腺癌的后线用药。结果显示,相比单药,各疗效指标有了长足的提升,有效率达16%、OS提升到16.4个月。安全性可靠。

且更为有趣的是,在入组治疗的44例三阴患者中,其中有12例属于既往伴有激素受体阳性,经过内分泌治疗后转化为三阴乳癌的患者。对于在这类既往内分泌型转化而来的三阴乳癌患者,盖新方案的有效率更高,达到50%,,中位OS是17.1个月。是该方案的优选人群。

哈佛医学院副教授Harold Burstein教授认为,能够将一线治疗的PFS延长到9或10个月的话就足以保证相应疗法的上市获批。

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    2020-11-13 tamgche
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    2020-05-01 10518094zz
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    2020-05-01 xlysu
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    2020-05-01 Luyuxie_14

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