BACKGROUND Hepatocellular carcinoma(HCC)patients complicated with portal vein tumor thrombus(PVTT)exhibit poor prognoses and treatment responses.AIM To investigate efficacies and safety of the combination of PD-1 inhi...BACKGROUND Hepatocellular carcinoma(HCC)patients complicated with portal vein tumor thrombus(PVTT)exhibit poor prognoses and treatment responses.AIM To investigate efficacies and safety of the combination of PD-1 inhibitor,transcatheter arterial chemoembolization(TACE)and Lenvatinib in HCC subjects comorbid with PVTT.METHODS From January 2019 to December 2020,HCC patients with PVTT types Ⅰ-Ⅳ were retrospectively enrolled at Beijing Ditan Hospital.They were distributed to either the PTL or TACE/Lenvatinib(TL)group.The median progression-free survival(mPFS)was set as the primary endpoint,while parameters like median overall survival,objective response rate,disease control rate(DCR),and toxicity level served as secondary endpoints.RESULTS Forty-one eligible patients were finally recruited for this study and divided into the PTL(n=18)and TL(n=23)groups.For a median follow-up of 21.8 months,the DCRs were 88.9%and 60.9%in the PTL and TL groups(P=0.046),res-pectively.Moreover,mPFS indicated significant improvement(HR=0.25;P<0.001)in PTL-treated patients(5.4 months)compared to TL-treated(2.7 months)patients.There were no treatment-related deaths or differences in adverse events in either group.CONCLUSION A triplet regimen of PTL was safe and well-tolerated as well as exhibited favorable efficacy over the TL regimen for advanced-stage HCC patients with PVTT types Ⅰ-Ⅳ.展开更多
目的探究真实世界中程序性死亡蛋白1(Programmed Death Protein 1,PD-1)/程序性死亡蛋白配体1(Programmed Death Protein Ligand 1,PD-L1)抑制剂治疗对晚期非小细胞肺癌(Non-Small Cell Lung Cancer,NSCLC)二线及以上患者预后转归的影...目的探究真实世界中程序性死亡蛋白1(Programmed Death Protein 1,PD-1)/程序性死亡蛋白配体1(Programmed Death Protein Ligand 1,PD-L1)抑制剂治疗对晚期非小细胞肺癌(Non-Small Cell Lung Cancer,NSCLC)二线及以上患者预后转归的影响。方法选取2019年1月—2023年7月涟水县人民医院就诊的112例晚期NSCLC二线及以上患者为研究对象,依据治疗方法分为两组,每组56例,对照组接受二线及以上单药化疗,观察组接受PD-1/PD-L1抑制剂免疫治疗,对比两组生存质量、无进展生存期、总生存期及不良反应发生率。结果化疗4个周期后,观察组生存质量评分显著高于对照组,差异有统计学意义(P<0.05)。观察组无进展生存期、总生存期显著优于对照组,差异有统计学意义(P均<0.05)。观察组不良反应发生率显著低于对照组,且观察组高血压发生人数显著少于对照组,差异有统计学意义(P均<0.05)。结论晚期NSCLC患者二线治疗中PD-1/PD-L1抑制剂免疫治疗能提升患者生存质量,降低其不良反应发生率。展开更多
肝细胞癌(hepatocellular carcinoma,HCC)是全球高发的恶性肿瘤。程序性死亡蛋白-1(programmed death protein-1,PD-1)/程序性死亡蛋白配体-1(programmed death protein ligand-1,PD-L1)抑制剂可通过阻断T细胞负调节信号,抑制肿瘤细胞...肝细胞癌(hepatocellular carcinoma,HCC)是全球高发的恶性肿瘤。程序性死亡蛋白-1(programmed death protein-1,PD-1)/程序性死亡蛋白配体-1(programmed death protein ligand-1,PD-L1)抑制剂可通过阻断T细胞负调节信号,抑制肿瘤细胞免疫逃逸途径,重新激活抗肿瘤免疫应答过程,成为晚期HCC治疗的新手段。然而,长期临床结果显示,采用PD-1/PD-L1抑制剂单药治疗晚期HCC的病人仍存在较高的复发率和转移率。免疫联合疗法是目前针对晚期HCC患者的新的治疗策略,其中PD-1/PD-L1抑制剂联合抗血管内皮生长因子(vascular endothelial growth factor,VEGF)药物在晚期HCC治疗中显示出了良好的疗效和安全性。PD-1/PD-L1抑制剂联合抗VEGF药物可通过参与癌症免疫循环途径抑制肝癌细胞的生长。该文就PD-1/PD-L1抑制剂联合抗VEGF药物在晚期HCC治疗中的临床研究作一综述。展开更多
靶向细胞程序性死亡受体-1(programmed cell death protein-1,PD-1)/细胞程序性死亡配体-1(programmed cell death ligand-1,PD-L1)已成为最具前景的肿瘤免疫治疗靶点之一。目前,PD-1/PD-L1单克隆抗体药物及小分子抑制剂都面临着相应的...靶向细胞程序性死亡受体-1(programmed cell death protein-1,PD-1)/细胞程序性死亡配体-1(programmed cell death ligand-1,PD-L1)已成为最具前景的肿瘤免疫治疗靶点之一。目前,PD-1/PD-L1单克隆抗体药物及小分子抑制剂都面临着相应的发展瓶颈,许多研究者尝试探索不同的策略以阻断PD-L1/PD-L1通路,期望改善肿瘤治疗的效果。本文总结了靶向PD-L1的降解剂、双功能分子及共价抑制剂,旨在为PD-1/PD-L1药物的开发提供有益的思路。展开更多
目的:评估细胞程序性死亡-配体1(PD-L1)程序性细胞死亡受体1(PD-1)水平在PD-1/PD-L1抑制剂[PD-(L)1]治疗晚期实体肿瘤中的疗效预测价值。方法:系统检索了PubMed、CNKI、万方等数据库,收集PD-(L)1抑制剂治疗恶性肿瘤患者的相关研究,检索...目的:评估细胞程序性死亡-配体1(PD-L1)程序性细胞死亡受体1(PD-1)水平在PD-1/PD-L1抑制剂[PD-(L)1]治疗晚期实体肿瘤中的疗效预测价值。方法:系统检索了PubMed、CNKI、万方等数据库,收集PD-(L)1抑制剂治疗恶性肿瘤患者的相关研究,检索时限为各数据库建库至2022年12月28日。由两名研究者独立评价纳入研究的质量并提取资料,采用Stata 16.0和Rev Man 5.4进行Meta分析。结果:Meta分析结果显示,PD-L1阳性和阴性的晚期实体瘤患者在PD-(L)1抑制剂的治疗总生存期(OS)中差异无统计学意义(P>0.05),同样在常规药物治疗中二者有效性差异无统计学意义(P>0.05);与常规药物相比,PD-(L)1抑制剂显著延长PD-L1表达阳性患者和PD-L1阴性患者的OS;基于药物靶点、疾病、免疫组化评分类型和中位随访时间等方面亚组分析进一步佐证了以上结果。结论:PD-L1的表达状态(以1%为临界值)不足以作为预测使用PD-(L)1抑制剂治疗患者的OS;PD-L1阳性及阴性晚期肿瘤患者均可从抑制剂及常规药物治疗中获益;无论PD-L1的表达状态如何,与常规药物相比,PD-(L)1抑制剂都显著延长了晚期实体肿瘤患者的OS。展开更多
Lung cancer is a malignant tumor with high incidence and mortality rates in China and worldwide.Approximately 10%of these diseases are caused by multiple primary non-small cell lung cancers(NSCLC).Traditional antitumo...Lung cancer is a malignant tumor with high incidence and mortality rates in China and worldwide.Approximately 10%of these diseases are caused by multiple primary non-small cell lung cancers(NSCLC).Traditional antitumor therapies,such as chemotherapy,radiotherapy,and targeted therapy,have limited efficacy in the treatment of advanced synchronous multiple primary NSCLC.Immunotherapy is considered the standard of care for advanced or recurrent NSCLC,however,approximately 60%of patients develop primary or secondary resistance to treatment.There are no standard recommendations for overcoming immune resistance.We describe a case of simultaneous multiple primary NSCLC in a patient who received programmed death factor-1(PD-1)inhibitor monotherapy and developed brain metastases.After receiving second-line treatment with a combination of another PD-1 inhibitor,pemetrexed,and bevacizumab,the patient achieved complete remission,although they experienced grade 3 immune-related adverse reactions.Immune re-challenge is safe and feasible,and choosing a synergistic combination regimen is one of the options to overcome immune resistance.A larger sample size is needed to confirm the effectiveness and safety of this strategy in patients with NSCLC resistant to prior PD-1 inhibitors.展开更多
基金The study was reviewed and approved by the Beijing Ditan Hospital,Capital Medical University Institutional Review Board(Approval No.JDLC 2021-003-02).
文摘BACKGROUND Hepatocellular carcinoma(HCC)patients complicated with portal vein tumor thrombus(PVTT)exhibit poor prognoses and treatment responses.AIM To investigate efficacies and safety of the combination of PD-1 inhibitor,transcatheter arterial chemoembolization(TACE)and Lenvatinib in HCC subjects comorbid with PVTT.METHODS From January 2019 to December 2020,HCC patients with PVTT types Ⅰ-Ⅳ were retrospectively enrolled at Beijing Ditan Hospital.They were distributed to either the PTL or TACE/Lenvatinib(TL)group.The median progression-free survival(mPFS)was set as the primary endpoint,while parameters like median overall survival,objective response rate,disease control rate(DCR),and toxicity level served as secondary endpoints.RESULTS Forty-one eligible patients were finally recruited for this study and divided into the PTL(n=18)and TL(n=23)groups.For a median follow-up of 21.8 months,the DCRs were 88.9%and 60.9%in the PTL and TL groups(P=0.046),res-pectively.Moreover,mPFS indicated significant improvement(HR=0.25;P<0.001)in PTL-treated patients(5.4 months)compared to TL-treated(2.7 months)patients.There were no treatment-related deaths or differences in adverse events in either group.CONCLUSION A triplet regimen of PTL was safe and well-tolerated as well as exhibited favorable efficacy over the TL regimen for advanced-stage HCC patients with PVTT types Ⅰ-Ⅳ.
文摘目的探究真实世界中程序性死亡蛋白1(Programmed Death Protein 1,PD-1)/程序性死亡蛋白配体1(Programmed Death Protein Ligand 1,PD-L1)抑制剂治疗对晚期非小细胞肺癌(Non-Small Cell Lung Cancer,NSCLC)二线及以上患者预后转归的影响。方法选取2019年1月—2023年7月涟水县人民医院就诊的112例晚期NSCLC二线及以上患者为研究对象,依据治疗方法分为两组,每组56例,对照组接受二线及以上单药化疗,观察组接受PD-1/PD-L1抑制剂免疫治疗,对比两组生存质量、无进展生存期、总生存期及不良反应发生率。结果化疗4个周期后,观察组生存质量评分显著高于对照组,差异有统计学意义(P<0.05)。观察组无进展生存期、总生存期显著优于对照组,差异有统计学意义(P均<0.05)。观察组不良反应发生率显著低于对照组,且观察组高血压发生人数显著少于对照组,差异有统计学意义(P均<0.05)。结论晚期NSCLC患者二线治疗中PD-1/PD-L1抑制剂免疫治疗能提升患者生存质量,降低其不良反应发生率。
文摘肝细胞癌(hepatocellular carcinoma,HCC)是全球高发的恶性肿瘤。程序性死亡蛋白-1(programmed death protein-1,PD-1)/程序性死亡蛋白配体-1(programmed death protein ligand-1,PD-L1)抑制剂可通过阻断T细胞负调节信号,抑制肿瘤细胞免疫逃逸途径,重新激活抗肿瘤免疫应答过程,成为晚期HCC治疗的新手段。然而,长期临床结果显示,采用PD-1/PD-L1抑制剂单药治疗晚期HCC的病人仍存在较高的复发率和转移率。免疫联合疗法是目前针对晚期HCC患者的新的治疗策略,其中PD-1/PD-L1抑制剂联合抗血管内皮生长因子(vascular endothelial growth factor,VEGF)药物在晚期HCC治疗中显示出了良好的疗效和安全性。PD-1/PD-L1抑制剂联合抗VEGF药物可通过参与癌症免疫循环途径抑制肝癌细胞的生长。该文就PD-1/PD-L1抑制剂联合抗VEGF药物在晚期HCC治疗中的临床研究作一综述。
文摘靶向细胞程序性死亡受体-1(programmed cell death protein-1,PD-1)/细胞程序性死亡配体-1(programmed cell death ligand-1,PD-L1)已成为最具前景的肿瘤免疫治疗靶点之一。目前,PD-1/PD-L1单克隆抗体药物及小分子抑制剂都面临着相应的发展瓶颈,许多研究者尝试探索不同的策略以阻断PD-L1/PD-L1通路,期望改善肿瘤治疗的效果。本文总结了靶向PD-L1的降解剂、双功能分子及共价抑制剂,旨在为PD-1/PD-L1药物的开发提供有益的思路。
文摘目的:评估细胞程序性死亡-配体1(PD-L1)程序性细胞死亡受体1(PD-1)水平在PD-1/PD-L1抑制剂[PD-(L)1]治疗晚期实体肿瘤中的疗效预测价值。方法:系统检索了PubMed、CNKI、万方等数据库,收集PD-(L)1抑制剂治疗恶性肿瘤患者的相关研究,检索时限为各数据库建库至2022年12月28日。由两名研究者独立评价纳入研究的质量并提取资料,采用Stata 16.0和Rev Man 5.4进行Meta分析。结果:Meta分析结果显示,PD-L1阳性和阴性的晚期实体瘤患者在PD-(L)1抑制剂的治疗总生存期(OS)中差异无统计学意义(P>0.05),同样在常规药物治疗中二者有效性差异无统计学意义(P>0.05);与常规药物相比,PD-(L)1抑制剂显著延长PD-L1表达阳性患者和PD-L1阴性患者的OS;基于药物靶点、疾病、免疫组化评分类型和中位随访时间等方面亚组分析进一步佐证了以上结果。结论:PD-L1的表达状态(以1%为临界值)不足以作为预测使用PD-(L)1抑制剂治疗患者的OS;PD-L1阳性及阴性晚期肿瘤患者均可从抑制剂及常规药物治疗中获益;无论PD-L1的表达状态如何,与常规药物相比,PD-(L)1抑制剂都显著延长了晚期实体肿瘤患者的OS。
文摘Lung cancer is a malignant tumor with high incidence and mortality rates in China and worldwide.Approximately 10%of these diseases are caused by multiple primary non-small cell lung cancers(NSCLC).Traditional antitumor therapies,such as chemotherapy,radiotherapy,and targeted therapy,have limited efficacy in the treatment of advanced synchronous multiple primary NSCLC.Immunotherapy is considered the standard of care for advanced or recurrent NSCLC,however,approximately 60%of patients develop primary or secondary resistance to treatment.There are no standard recommendations for overcoming immune resistance.We describe a case of simultaneous multiple primary NSCLC in a patient who received programmed death factor-1(PD-1)inhibitor monotherapy and developed brain metastases.After receiving second-line treatment with a combination of another PD-1 inhibitor,pemetrexed,and bevacizumab,the patient achieved complete remission,although they experienced grade 3 immune-related adverse reactions.Immune re-challenge is safe and feasible,and choosing a synergistic combination regimen is one of the options to overcome immune resistance.A larger sample size is needed to confirm the effectiveness and safety of this strategy in patients with NSCLC resistant to prior PD-1 inhibitors.
