Oncologist:Nivolumab加低剂量Ipilimumab为既往治疗的微卫星不稳定及高/错配修复缺陷型转移性结直肠癌患者提供新的治疗选择

2020-09-30 MedSci原创 MedSci原创

在接受免疫检查点抑制剂的患者中,早期发现和处理治疗相关的不良事件(TRAEs)可以改善治疗结果。在CheckMate 142中,nivolumab(3 mg/kg)加低剂量ipilimumab(1 m

在接受免疫检查点抑制剂的患者中,早期发现和处理治疗相关的不良事件(TRAEs)可以改善治疗结果。在CheckMate 142中,nivolumab(3 mg/kg)加低剂量ipilimumab(1 mg/kg)为既往治疗的微卫星不稳定,高和/或错配修复缺陷(MSI-H/dMMR)转移性结直肠癌(mCRC)提供了持久的临床获益(客观反应率[ORR]55%,中位反应持续时间未达到,12个月总生存[OS]率85%)和可控的安全性。本文介绍了CheckMate 142的深度安全性和额外疗效结果。

安全性评估包括TRAEs、选择性TRAEs(sTRAEs)和免疫介导的不良事件发生率;发病时间(TTO);解决时间(TTR);免疫调节药物(IMM)的使用;剂量延迟;以及恢复治疗后sTRAE的发生。疗效评估包括有或没有同时进行IMM治疗的sTRAEs患者和没有sTRAEs患者的ORR和生存分析。

 

结果显示,在119例患者中,分别有25%、23%、19%、5%、5%和29%的患者发生了内分泌、胃肠、肝、肺、肾或皮肤sTRAE,大多数(57%)为1/2级,sTRAE发生较早(中位TTO,5.2-12.6周)。大多数(>71%)患者的非内分泌sTRAEs得到缓解(中位TTR,1.5-9.0周)。22%-56%的患者使用IMMs来管理sTRAEs(大多数得到缓解)。在因sTRAEs而导致剂量延迟的患者中,29例中有25例恢复了治疗。有或没有sTRAEs的患者的ORR(57% vs. 52%)和12个月OS率(93% vs. 75%)相当。无论是否使用IMM,在有或没有sTRAEs的患者中也观察到类似的结果(ORR 52% vs. 57%;OS率87% vs. 82%)。

综上所述,该研究结果表明,nivolumab加低剂量ipilimumab的获益-风险曲线为既往治疗过的MSI-H/dMMR mCRC患者提供了一个有希望的治疗选择。

 

原始出处:

 

Michael A MorseMichael J Overman, et al., Safety of Nivolumab plus Low-Dose Ipilimumab in Previously Treated Microsatellite Instability-High/Mismatch Repair-Deficient Metastatic Colorectal Cancer. Oncologist. 2019 Nov;24(11):1453-1461. doi: 10.1634/theoncologist.2019-0129. 

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    2021-06-14 tamgche
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createdBy=015a38388258, createdName=liye789132264, createdTime=Tue Dec 22 17:54:53 CST 2020, time=2020-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2007920, encodeId=9816200e92066, content=<a href='/topic/show?id=601512826f6' target=_blank style='color:#2F92EE;'>#NIV#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, 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=Mon Jun 14 16:54:53 CST 2021, time=2021-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2078507, encodeId=a8c220e850783, content=<a href='/topic/show?id=9cf9505582e' target=_blank style='color:#2F92EE;'>#微卫星#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, 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objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=9997, encryptionId=8d16999eda, topicName=Ipilimumab)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Fri Oct 02 14:54:53 CST 2020, time=2020-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1386670, encodeId=ccf613866e03b, content=<a href='/topic/show?id=f08293399f9' target=_blank style='color:#2F92EE;'>#转移性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93399, encryptionId=f08293399f9, topicName=转移性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ac22500003, createdName=1249842em09(暂无昵称), createdTime=Fri Oct 02 14:54:53 CST 2020, time=2020-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1453425, 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createdTime=Fri Oct 02 14:54:53 CST 2020, time=2020-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480583, encodeId=bc8b148058391, content=<a href='/topic/show?id=647d2615939' target=_blank style='color:#2F92EE;'>#低剂量#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26159, encryptionId=647d2615939, topicName=低剂量)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=97b17641126, createdName=ms1292405679162969, createdTime=Fri Oct 02 14:54:53 CST 2020, time=2020-10-02, status=1, ipAttribution=)]
    2021-09-04 qjddjq
  5. [GetPortalCommentsPageByObjectIdResponse(id=1645534, encodeId=b7da1645534ff, content=<a href='/topic/show?id=20c296e40e2' target=_blank style='color:#2F92EE;'>#错配修复缺陷#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96740, encryptionId=20c296e40e2, topicName=错配修复缺陷)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a68823222118, createdName=李研东, createdTime=Sat Dec 19 15:54:53 CST 2020, time=2020-12-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1772736, encodeId=c8191e7273651, content=<a href='/topic/show?id=871064e139b' target=_blank style='color:#2F92EE;'>#治疗选择#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64713, encryptionId=871064e139b, topicName=治疗选择)], attachment=null, authenticateStatus=null, createdAvatar=null, 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createdTime=Fri Oct 02 14:54:53 CST 2020, time=2020-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480583, encodeId=bc8b148058391, content=<a href='/topic/show?id=647d2615939' target=_blank style='color:#2F92EE;'>#低剂量#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26159, encryptionId=647d2615939, topicName=低剂量)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=97b17641126, createdName=ms1292405679162969, createdTime=Fri Oct 02 14:54:53 CST 2020, time=2020-10-02, status=1, ipAttribution=)]
    2021-05-02 minlingfeng
  6. [GetPortalCommentsPageByObjectIdResponse(id=1645534, encodeId=b7da1645534ff, content=<a href='/topic/show?id=20c296e40e2' target=_blank style='color:#2F92EE;'>#错配修复缺陷#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96740, encryptionId=20c296e40e2, topicName=错配修复缺陷)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a68823222118, createdName=李研东, createdTime=Sat Dec 19 15:54:53 CST 2020, time=2020-12-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1772736, encodeId=c8191e7273651, content=<a href='/topic/show?id=871064e139b' target=_blank style='color:#2F92EE;'>#治疗选择#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64713, encryptionId=871064e139b, topicName=治疗选择)], attachment=null, authenticateStatus=null, createdAvatar=null, 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  7. [GetPortalCommentsPageByObjectIdResponse(id=1645534, encodeId=b7da1645534ff, content=<a href='/topic/show?id=20c296e40e2' target=_blank style='color:#2F92EE;'>#错配修复缺陷#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96740, encryptionId=20c296e40e2, topicName=错配修复缺陷)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a68823222118, createdName=李研东, createdTime=Sat Dec 19 15:54:53 CST 2020, time=2020-12-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1772736, encodeId=c8191e7273651, content=<a href='/topic/show?id=871064e139b' target=_blank style='color:#2F92EE;'>#治疗选择#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64713, encryptionId=871064e139b, topicName=治疗选择)], attachment=null, authenticateStatus=null, createdAvatar=null, 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createdTime=Fri Oct 02 14:54:53 CST 2020, time=2020-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480583, encodeId=bc8b148058391, content=<a href='/topic/show?id=647d2615939' target=_blank style='color:#2F92EE;'>#低剂量#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26159, encryptionId=647d2615939, topicName=低剂量)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=97b17641126, createdName=ms1292405679162969, createdTime=Fri Oct 02 14:54:53 CST 2020, time=2020-10-02, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=1645534, encodeId=b7da1645534ff, content=<a href='/topic/show?id=20c296e40e2' target=_blank style='color:#2F92EE;'>#错配修复缺陷#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96740, encryptionId=20c296e40e2, topicName=错配修复缺陷)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a68823222118, createdName=李研东, createdTime=Sat Dec 19 15:54:53 CST 2020, time=2020-12-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1772736, encodeId=c8191e7273651, content=<a href='/topic/show?id=871064e139b' target=_blank style='color:#2F92EE;'>#治疗选择#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64713, encryptionId=871064e139b, topicName=治疗选择)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=015a38388258, createdName=liye789132264, createdTime=Tue Dec 22 17:54:53 CST 2020, time=2020-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2007920, encodeId=9816200e92066, content=<a href='/topic/show?id=601512826f6' target=_blank style='color:#2F92EE;'>#NIV#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, 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=Mon Jun 14 16:54:53 CST 2021, time=2021-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2078507, encodeId=a8c220e850783, content=<a href='/topic/show?id=9cf9505582e' target=_blank style='color:#2F92EE;'>#微卫星#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, 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  9. [GetPortalCommentsPageByObjectIdResponse(id=1645534, encodeId=b7da1645534ff, content=<a href='/topic/show?id=20c296e40e2' target=_blank style='color:#2F92EE;'>#错配修复缺陷#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96740, encryptionId=20c296e40e2, topicName=错配修复缺陷)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a68823222118, createdName=李研东, createdTime=Sat Dec 19 15:54:53 CST 2020, time=2020-12-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1772736, encodeId=c8191e7273651, content=<a href='/topic/show?id=871064e139b' target=_blank style='color:#2F92EE;'>#治疗选择#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64713, encryptionId=871064e139b, topicName=治疗选择)], attachment=null, authenticateStatus=null, createdAvatar=null, 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    2020-10-02 july_977
  10. 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