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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 | Human papillomavirus and cervical cancer显示文摘 | Mark Schiffman Philip E Castle Jose Jeronimo Ana C Rodriguez Sholom Wacholder | 2007 | 2007 (9590)2007，，9590： | 2 |
| 3 | Human papillomavirus and cervical cancer显示文摘 | Mark Schiffman Philip E Castle Jose Jeronimo Ana C Rodriguez Sholom Wacholder | 2007 | The Lancet . 2007 (9590)2007，，9590： | 2 |
| 4 | Positive correla tion of tissue inhibitor of metalloproteinase 3 and death associated protein kinase hypermethylation in head and neck squamous cell carcinoma显示文摘 | Nayak C S Carvalho A L Jeronimo C | 2007 | Laryngoscope2007，117，8： | 1 |
| 5 | Positive correlation of tissue inhibitor of metalloproteinase-3 and deathassociated protein kinase hypermethylation in head and neck squamous cell carcinoma 显示文摘 | Nayak CS Carvalho AL Jeronimo C | 2007 | Laryngoscope2007，117，8： | 1 |
| 6 | A quantitative promoter methylation profile of prostate cancer 显示文摘 | Jeronimo C Henrique R Hoque MO | 2004 | Clin Cancer Res2004，10，24： | 1 |
| 7 | A quantitative promoter methylation profile of prostate cancer 显示文摘 | Jeronimo C Henrique R Hoque MO | 2004 | Clin Cancer Res2004，10，24： | 1 |
| 8 | Quantitative methylation profiling of renal tumors and the discovery of a new generation of molecular markers显示文摘 | JERONIMO C | 2005 | Future Oncol2005，1，2： | 1 |
| 9 | Molecular detection of prostate cancer : a role for GSTPI hypermethylation显示文摘 | Henrique R Jeronimo C | 2004 | European Urology2004，46，5： | 1 |
| 10 | Detection of gene promoter hypermethylation in fine needle washings from breast lesions 显示文摘 | Jeronimo C Costa I Martins MC | 2003 | Clin Cancer Res2003，9，： | 1 |
| 11 | Evaluation of promoter hypermethylation detection in body fluids as a screening/diagnosis tool for head and neck squamous cell carcinoma显示文摘 | Carvalho AL Jeronimo C Kim MM | 2008 | Clin Cancer Res2008，14，1： | 1 |
| 12 | Evaluation of promoter hethylation detection in body fluids as a screening/diagnosis tool for head and neck squamous cell carcinoma显示文摘 | Carvalho AL Jeronimo C Kim MM | 2008 | Clin Cancer Res2008，14，1： | 1 |
| 13 | Optical sensors and biosensors based on sol-gel films显示文摘 | Jeronimo P C Arafljo A N Montenegro M C | 2007 | Talanta2007，72，1： | 1 |
| 14 | Frequent 14-3-3σ promoter methylation in benign and malignant prostate lesions 显示文摘 | Henrique R Jeronimo C Hoque M | 2005 | DNA Cell Biolog2005，24，4： | 1 |
| 15 | Quantitative RARbeta2 hypermethylation: a promising prostate cancer marker显示文摘 | Jeronimo C Henrique R Hoque MO | 2004 | Clin Cancer Res2004，10，121： | 1 |
| 16 | Mitochondrial mutations in early stage prostate cancer and bodily fluids显示文摘 | Jeronimo C Nomoto S Caballero OL | 2001 | Oncogene2001，20，37： | 1 |
| 17 | Impotance of M-protein C termiuns as substrate antigen for serodetection of equine arteritis virus infection显示文摘 | Jeronimo C A | 2002 | Clin Diangno Labo Immunol2002，，4： | 1 |
| 18 | Epigenetics in prostate cancer:biologic and clinical relevance显示文摘 | Jeronimo C Bastian PJ Bjartell A | 2011 | Eur Urol2011，60，4： | 1 |
| 19 | Hypermethylation of MCAM gene is associated with advanced tumor stage in prostate cancer显示文摘 | LIU J W NAGPAL J K JERONIMO C | 2008 | Prostate2008，68，4： | 1 |
| 20 | Mitochondrial mutations in early stage prostate cancer and bodily fluids显示文摘 | Jeronimo C Nomoto S Caballero OL | 2001 | Oncogene2001，20，： | 1 |
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