|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | 帕博利珠单抗单用或与放疗联用治疗转移性非小细胞肺癌:两个随机试验的汇总分析显示文摘背景放疗可以提高整个机体对免疫治疗的应答。在Ⅱ期PEMBRO-RT研究和Ⅰ/Ⅱ期MDACC研究中,患有转移性非小细胞肺癌(NSCLC)的患者被随机分配入组,接受免疫治疗(帕博利珠单抗)+放疗联合疗法,或免疫治疗单一疗法。当上述2个研究单独分析时,联合疗法组显示出潜在获益。由于每个研究的样本量较小,缓解率和结局并未显示出统计学意义,然而却有显著的临床获益。因此,本研究进行汇总分析,来判断放疗是否会改善转移性NSCLC患者的免疫治疗应答。方法PEMBRO-RT和MDACC研究纳入标准:患者年龄≥18岁,患有转移性NSCLC,且有≥1处未经放疗照射的病灶,以便进行射野外应答监测。PEMBRO-RT研究纳入曾接受过化疗患者,MDACC研究纳入曾接受过治疗或新诊断患者。2个研究中的患者均未接受过免疫治疗。在PEMBRO-RT研究中患者被等比例随机分配入组,并根据吸烟状态进行分层(分为<10年组和≥10年组)。MDACC研究的患者根据放疗计划可行性被等比例随机分配入2个受试组。由于联合治疗组的干预本质,每个研究中的放疗均不适用盲法。在2个研究中,不论是否进行放疗,均静脉滴入帕博利珠单抗(每3周200 mg)。在PEMBRO-RT研究中,在放疗(24 Gy 3次分割照射)结束后1周给予第1剂帕博利珠单抗。在MDACC研究中,在第1次放疗(50 Gy 4次分割照射或45 Gy 15次分割照射)同时给予帕博利珠单抗。仅检测未经照射病灶的应答。本研究的终点为最佳射野外(远隔)应答率(ARR)、最佳射野外疾病控制率(ACR)、12周时ARR、12周时ACR、无进展生存期(PFS)和总生存期(OS)。2个研究的意向治疗(ITT)人群均纳入分析。PEMBRO-RT研究(NCT02492568)和MDACC研究(NCT02444741)均在ClinicalTrials.gov上注册。发现纳入148例患者,76例接受帕博利珠单抗治疗,72例接受帕博利珠单抗+放疗治疗。所有患者随访时间中位数为33个月[四分位距(IQR):32.4~33.6]。148例患者中124例(84%)组织学特征为非鳞癌,111例(75%)患者曾经接受过化疗。组间没有基线特征差异,包括PD-L1表达状态和转移灶体积。最常见的照射部位为肺转移灶(39%,28/72)、胸腔内淋巴结(21%,15/72)和非原发灶(17%,12/72)。帕博利珠单抗组和联合治疗组的最佳ARR分别为19.7%(15/76)和41.7%(30/72),OR=2.96,95%CI:1.42~6.20,P=0.0039;最佳ACR分别为43.4%(33/76)和65.3%(47/72),OR=2.51,95%CI:1.28~4.91,P=0.0071;PFS中位数分别为4.4(IQR:2.9~5.9)和9.0个月(IQR:6.8~11.2),HR=0.67,95%CI:0.45~0.99,P=0.045;OS中位数分别为8.7(IQR:6.4~11.0)和19.2个月(IQR:14.6~23.8),OR=0.67,95%CI:0.54~0.84,P=0.0004。在汇总分析中没有发现新的安全问题。解读帕博利珠单抗免疫疗法+放疗显著提高转移性NSCLC患者的应答和改善治疗结局。这些结果需要在三期临床试验中进行验证。 | 陈大卫(翻译) 于金明(校对) Willemijn S M E Theelen Vivek Verma Brian P Hobbs Heike M U Peulen Joachim G J V Aerts Idris Bahce Anna Larissa N Niemeijer Joe Y Chang Patricia M de Groot Quynh-Nhu Nguyen Nathan I Comeaux George R Simon Ferdinandos Skoulidis Steven H Lin Kewen He Roshal Patel John Heymach Paul Baas James W Welsh | 2021 | 中华肿瘤防治杂志2021，28，24： | 49 |
| 2 | An MDP-based vertical handoff decision algorithm for heterogeneous wireless net- works 显示文摘 | Stevens Navarro E Lin Y X Vincent Wong W S | 2008 | IEEE Transactions on Vehicular Technology2008，57，2： | 1 |
| 3 | Psoriasis and hypertension severity: results from a case - control study显示文摘 | April W Armstrong Steven W Lin Cynthia J Chambers | 2011 | PLoS One2011，6，18： | 1 |
| 4 | An MDP-Based Vertical Handoff Decision Algorithm for Heterogeneous Wireless Networks 显示文摘 | STEVENS Navarro E LIN Y X WONG V W S | 2008 | IEEE Trans Vehi Tech2008，57，2： | 1 |
| 5 | An MDP-based vertical handoff decision algorithm for heterogeneous wireless networks 显示文摘 | Stevens Navarro E Lin Y X Wong V W S | 2008 | IEEE Trans Vehi Tech2008，57，2： | 1 |
| 6 | Sensitivity derivatives of eigendata of one-dimensional structural systems显示文摘 | Murthy V R LIN Yu-an O' Hara W Steven | 2001 | J AIAA2001，38，1： | 1 |
| 7 | An MDP-based Vertical Handoff Decision Algorithm for Heterogeneous Wireless Networks显示文摘 | STEVENS N E LIN Y X WONG V W S | 2008 | IEEE Trans Vehi Tech2008，57，02： | 1 |
| 8 | Substantial hepatic necrosis is prognostic in fulminant liver failure显示文摘AIM To evaluate if any association existed between the extent of hepatic necrosis in initial liver biopsies and patient survival.METHODS Thirty-seven patients with fulminant liver failure, whose liver biopsy exhibited substantial necrosis, were identified and included in the study. The histological and clinical data was then analyzed in order to assess the relationship between the extent of necrosis and patient survival, with and without liver transplantation. The patients were grouped based on the etiology of hepatic necrosis. Each of the etiology groups were then further stratified according to whether or not they had received a liver transplant post-index biopsy, and whether or not the patient survived.RESULTS The core tissue length ranged from 5 to 44 mm with an average of 23 mm. Causes of necrosis included 14 autoimmune hepatitis, 10 drug induced liver injury(DILI), 9 hepatitis virus infection, and 4 unknown origin. Among them, 11 showed submassive(26%-75% of the parenchymal volume) and 26 massive(76%-100%) necrosis. Transplant-free survival was worse in patients with a higher extent of necrosis(40%, 71.4% and 100% in groups with necrosis of 76%-100%, 51%-75%and 26%-50%, respectively). Additionally, transplantfree survival rates were 66.7%, 57.1%, and 25.0% in groups of autoimmune hepatitis, DILI, and viral hepatitis, respectively. Even after liver transplantation, the survival rate in patients as a result of viral hepatitis remained the lowest(80%, 100%, and 40% in groups of autoimmune hepatitis, DILI, and viral hepatitis, respectively).CONCLUSION Adequate liver biopsy with more than 75% necrosis is associated with significant transplant-free mortality that is critical in predicting survival. | Paul Ndekwe Marwan S Ghabril Yong Zang Steven A Mann Oscar W Cummings Jingmei Lin | 2017 | World Journal of Gastroenterology2017，23，23： | 1 |
| 9 | Wave measurement and modeling in Chesapeake Bay 显示文摘 | Lin W Q Sanford L P Steven E | 2002 | Continental Shelf Research2002，22，： | 1 |
| 10 | Reinforcement learning of non- Markov decision processes显示文摘 | Steven D W Lin L J | 1995 | Artificial Intelligent1995，73，： | 1 |
| 11 | An MDP-base vertical handoff decision algorithm for heterogeneous wireless network 显示文摘 | STEVENS N E LIN Y WONG V W S | 2008 | IEEE Trans on Vehicular Technology2008，57，2： | 1 |
您所在的机构暂未开通此部分的功能，请联系管理员