SABCS 2015:PD-L1免疫治疗在三阴乳腺癌(TNBC)治疗中显示潜力(JAVELIN研究)

2015-12-21 MedSci MedSci原创

JAVELIN研究: avelumab(摘要号S1-04)来自匈牙利森梅威思大学的Luc Dirix教授在本次大会上报告了JAVELIN研究的结果。JAVELIN研究旨在探索PD-L1抑制剂avelumab治疗局部晚期或转移性乳腺癌患者的安全性和疗效。本项研究共入组168例患者,其中58例为三阴乳腺癌(TNBC)患者,72例为ER+/HER2-或PR+/HER2-患者,26例为HER2+患者。结果

JAVELIN研究: avelumab(摘要号S1-04)

来自匈牙利森梅威思大学的Luc Dirix教授在本次大会上报告了JAVELIN研究的结果。JAVELIN研究旨在探索PD-L1抑制剂avelumab治疗局部晚期或转移性乳腺癌患者的安全性和疗效。本项研究共入组168例患者,其中58例为三阴乳腺癌(TNBC)患者,72例为ER+/HER2-或PR+/HER2-患者,26例为HER2+患者。

结果显示,药物副作用在可接受的安全范围内,17例患者发生了免疫相关副作用,包括甲状腺功能低下、血小板减少以及自身免疫性肝炎。疗效数据显示,总有效率(ORR)占4.8%。Luc Dirix教授特别提到,在8例有效患者中有5例是三阴乳腺癌,也就是说在所有有效患者中三阴乳腺癌占到了62.5%。

进一步观察发现,PD-L1表达与疗效是否有相关性。从疗效上可以看到,在PD-L1表达阳性的患者中,有效率可以达到33.3%;而在PD-L1表达阴性的患者中,有效率则只有2.4%。另外,在5例TNBC的有效患者中,有4例是PD-L1阳性的患者。

MedSci编辑提示:

相对肺癌和黑色素瘤而言,乳腺癌中PD-L1阳性比例偏低,因此,未来PD-1/PD-L1类药物在乳腺癌中的应用可能存在局限性。但是,幸运的是,这部分人群往往是现在束手无策的TNBC。接下来,研究者们会关心如下课题:
(1)晚期或转移性TNBC中采用PD-1/PD-L1治疗,观察疗效。
(2)进一步在PD-1/PD-L1过表达的晚期或转移性TNBC中采用PD-1/PD-L1治疗,观察疗效。
(3)如果上述两个研究能证实,回答PD-1/PD-L1对于受体的选择性的问题。未来可能还是主要用于PD-1/PD-L1过表达的晚期或转移性TNBC。那么接下来,需要研究在这部分患者中,免疫治疗与化疗药物的结合(联合应用,还是序贯应用?)。实际上,一项正在进行的III期临床研究——Atezolizumab联合白蛋白紫杉醇治疗转移性三阴乳腺癌(mTNBC)正在进行中
(4)进一步,需要研究PD-1/PD-L1过表达的TNBC的一线治疗,以及一线治疗中与化疗药物的联合应用。
上述话题,将是未来5年内临床研究的热点。

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1777049, encodeId=b5c91e770498f, content=<a href='/topic/show?id=45ae1e1830' target=_blank style='color:#2F92EE;'>#ABC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1718, encryptionId=45ae1e1830, topicName=ABC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a54039078223, createdName=cmj21wellington, createdTime=Wed Sep 21 22:45:00 CST 2016, time=2016-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=95613, encodeId=b22c9561375, content=学习学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Wed Aug 03 05:48:00 CST 2016, time=2016-08-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=50635, encodeId=a75750635ee, content=我也是拼了, beContent=null, objectType=article, channel=null, level=null, likeNumber=113, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fe261399236, createdName=xyfg98, createdTime=Wed Dec 30 22:10:00 CST 2015, time=2015-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=49309, encodeId=be084930993, content=有意思, beContent=null, objectType=article, channel=null, level=null, likeNumber=176, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRiaKicWybj5Q5KN7PWibALciaJ4W5bZwTlDSFRibFu87125pCq0IXePrC0mpbiasADRqL4NcjUoyQCT9De/0, createdBy=7c7e1636498, createdName=wzf990214, createdTime=Sun Dec 27 12:21:00 CST 2015, time=2015-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=49310, encodeId=0156493103d, content=赞一个, beContent=null, objectType=article, channel=null, level=null, likeNumber=122, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfNLvzZhgPxRiaKicWybj5Q5KN7PWibALciaJ4W5bZwTlDSFRibFu87125pCq0IXePrC0mpbiasADRqL4NcjUoyQCT9De/0, createdBy=7c7e1636498, createdName=wzf990214, createdTime=Sun Dec 27 12:21:00 CST 2015, time=2015-12-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1254884, encodeId=b05212548847c, content=<a href='/topic/show?id=be71139214f' target=_blank style='color:#2F92EE;'>#PD-L1#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13921, encryptionId=be71139214f, topicName=PD-L1)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e76f39, createdName=smartjoy, createdTime=Tue Dec 22 23:45:00 CST 2015, time=2015-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1587499, encodeId=7657158e499fb, content=<a href='/topic/show?id=e03515826f8' target=_blank style='color:#2F92EE;'>#SABCS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15826, encryptionId=e03515826f8, topicName=SABCS)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=826117479684, createdName=guguangxiang, createdTime=Tue Dec 22 23:45:00 CST 2015, time=2015-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=46935, encodeId=3b8246935c9, content=高深, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7cde98330, createdName=milkshark, createdTime=Mon Dec 21 09:06:00 CST 2015, time=2015-12-21, status=1, ipAttribution=)]
    2016-08-03 1dd8c52fm63(暂无匿称)

    学习学习!

    0

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    2015-12-30 xyfg98

    我也是拼了

    0

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    2015-12-27 wzf990214

    有意思

    0

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    2015-12-27 wzf990214

    赞一个

    0

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    2015-12-22 smartjoy
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    2015-12-21 milkshark

    高深

    0

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