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| 1 | 帕博利珠单抗联合以铂类为基础的化疗治疗非小细胞肺癌合并稳定性脑转移患者的结局:KEYNOTE-021、-189和-407研究的汇总分析显示文摘背景与目的此项探索性分析回顾评价了晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者的结局,旨在确定基线时合并脑转移是否会影响一线应用帕博利珠单抗联合化疗(pembrolizumab plus chemotherapy,PC)比对单用化疗的疗效。患者和方法对KEYNOTE-021队列G(非鳞癌)、KEYNOTE-189(非鳞癌)和KEYNOTE-407(鳞癌)三项研究晚期NSCLC患者的数据进行汇总分析。患者接受含铂两药化疗和/或35个周期帕博利珠单抗治疗(每3周200 mg)。所有研究均纳入了经治或初治的稳定性脑转移患者(KEYNOTE-189与KEYNOTE-407研究纳入初治脑转移患者)。经治的脑转移患者已处于病情稳定的状态≥2周(KEYNOTE-021队列G患者≥4周),无新发或脑转移病灶扩大的证据且入组前至少3天以上未使用激素。初治的无症状脑转移患者需定期接受脑部影像学检查。结果共纳入1298例患者,其中171例有基线脑转移,1127例无脑转移。两组的中位随访时间(范围)在数据截止时分别为10.9(0.1-35.1)个月和11.0(0.1-34.9)个月。合并脑转移和无脑转移患者的总生存期[0.48(95%CI:0.32-0.70)和0.63(95%CI:0.53-0.75)]和无进展生存期[0.44(95%CI:0.31-0.62)和0.55(95%CI:0.48-0.63)]的风险比(PC/化疗)相似。合并脑转移的患者中,PC组和单用化疗组患者的中位总生存期分别为18.8个月和7.6个月,中位无进展生存期分别为6.9个月和4.1个月。无论是否合并脑转移,PC组患者的客观缓解率都高于单用化疗组,且缓解持续时间有显著延长。合并脑转移的患者中,PC组与单用化疗组的治疗相关不良事件发生率分别为88.2%和82.8%;而无脑转移的患者中,两组治疗相关不良事件的发生率分别为94.5%和90.6%。结论无论是否合并脑转移,与单用化疗相比,帕博利珠单抗联合以铂类为基础的组织学特异性化疗可改善所有PD-L1亚组的临床结局,其中包括PD-L1肿瘤比例评分<1%的患者,并且在晚期NSCLC患者中安全性良好。该方案是晚期NSCLC初治患者的标准方案,并可用于合并稳定性脑转移的患者。 | 周清(翻译校对) Steven F Powell Delvys Rodríguez-Abreu Corey J Langer Ali Tafreshi Luis Paz-Ares Hans-Georg Kopp Jeronimo Rodríguez-Cid Dariusz M Kowalski Ying Cheng Takayasu Kurata Mark M Awad Jinaxin Lin Bin Zhao M Catherine Pietanza Bilal Piperdi Marina C Garassino | 2022 | 中国肺癌杂志2022，25，1： | 6 |
| 2 | Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicentre randomised trial显示文摘 | JY Douillard D Cunningham AD Roth M Navarro RD James P Karasek P Jandik T Iveson J Carmichael M Alakl G Gruia L Awad P Rougier | 2000 | The Lancet2000，，9209： | 4 |
| 3 | On the Voltage Mirrors and the Current Mirrors显示文摘 | Awad I A Soliman A M | 2002 | Analog Integrated Circuits and Signal Processing2002，32，： | 1 |
| 4 | Expression of anglogenesis factors and selected vascular wall matrix proteins in intracranial saccular aneurysms 显示文摘 | Skirgaudas M Awad IA Kim J | 1996 | Neurosurgery1996，39，3： | 1 |
| 5 | New CMOS realization of the CCII- 显示文摘 | I A Awad A M Soliman | 1999 | IEEE transaction on circuits and systems-Ⅱ: Analog and digital signal processing1999，46，4： | 1 |
| 6 | Relationships between fruit nutrients and concentration of flavonoids and chlorogenic acid in Elstar apple skin显示文摘 | AWAD M A de JAGER A | 2002 | Sci Hortic2002，92，34： | 1 |
| 7 | Control strategies for Campylobacter infection in poultry production 显示文摘 | Ghareeb K Awad W A Mohnl M | 2013 | World''s Poultry Science Journal2013，69，1： | 1 |
| 8 | Exploring the value of online product reviews in forecasting sales: The case of motion pictures显示文摘 | Dellarocas C Zhang X M Awad N F | 2007 | Journal of interactive marketing2007，21，4： | 1 |
| 9 | A look on Fang number 显示文摘 | Awad M M | 2014 | ASME Jour- nal of Heat Transfer2014，13，6064502： | 1 |
| 10 | Flavonoid and chlorogenic acid levels in apple fruit: charactererisation of variation显示文摘 | AWAD M A JAGER A D WESTIN L M | 2000 | Sci Hort2000，83，： | 1 |
| 11 | Effect of sampling jitter on some sine wave measurements 显示文摘 | Wagdy M F Awad S S | 1990 | IEEE Transactions on Instrumentation and Measurement1990，39，1： | 1 |
| 12 | Multicomponent image segmentation: a comparative analysis between a hybrid genetic algorithm and self-organizing maps 显示文摘 | AWAD M M CHEHDI K NASRI A | 2009 | Int J Remote Sens2009，30，3： | 1 |
| 13 | A novel sine-wave generator using a single operational amplifier显示文摘 | SOLIMAN A M AWAD S S | 1978 | Proceedings of the IEEE1978，66，2： | 1 |
| 14 | The relationship between impaired glucose tolerance,type 2 diabetes,and congnitive function显示文摘 | Awad N Gagnon M Messier C | 2004 | J Clin Exp Neuropsychol2004，26，8： | 1 |
| 15 | The relationship between impaired glucose tolerance, type 2 diabetes, and cognitive funetion显示文摘 | Awad N Gagnon M Messier C | 2004 | J Clin Exp Neuropsychol2004，26，8： | 1 |
| 16 | Tuning Soft-ware Phase- locked Loop for Series-connected Converters 显示文摘 | AWAD H SVENSSON J BOLLEN M J | 2005 | IEEE Transactions on Power Delivery2005，21，1： | 1 |
| 17 | -sitosterol activates fas signaling in human breast cancer cells显示文摘 | Awad A B Chinnam M Fink C S | 2007 | Phytomedicine2007，14，： | 1 |
| 18 | Recurrent laryngeal nerve injury in thyroid surgery显示文摘 | ZAKARIA H M AL AWAD N A AL KREEDES A S | 2011 | Oman Med J2011，26，1： | 1 |
| 19 | The efficiency of electrostatic precipitators under conditions of corona quenching 显示文摘 | Awad M B Castle G S P | 1975 | Journal of Air Pollution Control Association1975，25，2： | 1 |
| 20 | Oscillations in the plethysmographic waveform amplitude: phenomenon hides behind artifacts显示文摘 | Cannesson M Awad AA Shelley K | 2009 | Anesthesiology2009，111，1： | 1 |
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