With the wide application of immunotherapy drug PD-1/PD-L1 inhibitor in China and the continuous clinical research,a major problem that we have to face is the immune-related pneumonia caused by PD-1/PD-L1.At present,w...With the wide application of immunotherapy drug PD-1/PD-L1 inhibitor in China and the continuous clinical research,a major problem that we have to face is the immune-related pneumonia caused by PD-1/PD-L1.At present,western medicine mainly treated it by hormone therapy,which may cause side effects,such as obesity,osteoporosis and osteonecrosis for hormone therapy by long-term,and increase the patients'pain.Under the guidance of the theory of syndrome differentiation,traditional Chinese medicine(TCM)advocates the methods of expelling wind and clearing away cold,resolving phlegm and relieving asthma,relieving heat from lung,and invigorating the spleen and tonifying the kidney,etc.Exact differentiation of symptoms and rational usage of drugs can play an important role in the early prevention and treatment of immune-related pneumonia,reflecting the important role of TCM in the prevention and treatment of side effects of new drugs.In order to provide an effective clinical reference for clinicians in the practice of using PD-1/PD-L1,this paper systematically reviewed the use of TCM in the treatment of immune-related pneumonia induced by PD-1/PD-L1 inhibitors.展开更多
Objective To explore the benefits and risks of PD-1/PD-L1 inhibitors Atezolizumab and Nivolumab in the treatment of non-squamous non-small cell lung cancer and provide some references for clinicians.Methods Based on t...Objective To explore the benefits and risks of PD-1/PD-L1 inhibitors Atezolizumab and Nivolumab in the treatment of non-squamous non-small cell lung cancer and provide some references for clinicians.Methods Based on the data results of relevant studies published by ClinicalTrical.gov in the US clinical trial database and foreign peer-reviewed journals,the internationally recognized multi-criteria decision analysis(MCDA)model was used to assess the benefit and risk of PD-1/PD-L1 inhibitors for non-squamous non-small lung cancer comprehensively.Finally,a sensitivity analysis was performed to test the sensitivity of the weight to the evaluation.Results and Conclusion The benefit-risk evaluation result of Atezolizumab for the treatment of non-squamous non-small cell lung cancer is better than that of Nivolumab.Specifically,Atezolizumab has more benefits than Nivolumab with a lower risk.The results of MCDA model in drug benefit and risk evaluation are easy to understand.However,the selection of indicators in the model and the degree of data acquisition are limited.The evaluation results of the MCDA model should be comprehensively viewed with other evaluations to make decisions objectively.展开更多
目的探讨肉瘤样肾细胞癌组织中PD-L1的表达及肿瘤内微血管密度情况,为肉瘤样肾细胞癌免疫治疗及靶向治疗方案的选择提供理论依据。方法通过免疫组化法检测PD-L1、CD31及CD34在16例肉瘤样肾细胞癌(癌成分均为透明细胞肾细胞癌)中的表达,...目的探讨肉瘤样肾细胞癌组织中PD-L1的表达及肿瘤内微血管密度情况,为肉瘤样肾细胞癌免疫治疗及靶向治疗方案的选择提供理论依据。方法通过免疫组化法检测PD-L1、CD31及CD34在16例肉瘤样肾细胞癌(癌成分均为透明细胞肾细胞癌)中的表达,并评估肿瘤微血管密度。结果16例肿瘤中CD31和CD34免疫组化染色显示,肉瘤样肾细胞癌区域微血管密度明显高于不伴肉瘤样分化的区域,微血管密度计数分别为68.6±25.8 vs 38.7±16.0(t=3.931,P=0.0005)和69.5±28.1 vs 40.1±18.4(t=3.506,P=0.0015),差异有统计学意义。肉瘤样区域PD-L1表达水平高于非肉瘤样区域,CPS分别为34.7±26.9和25.9±27.6,但差异无统计学意义。结论在肉瘤样肾细胞癌中,肉瘤样区域微血管密度和PD-L1表达水平明显高于非肉瘤样区域,提示靶向治疗联合免疫治疗可能为此类肿瘤提供一种有效的治疗方法。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
Background:As the efficacy of programmed cell death-1/programmed death-ligand 1(PD-1/PD-L1)inhibitors combined with chemotherapy in curing breast cancer is still controversial,this meta-analysis compares the efficacy ...Background:As the efficacy of programmed cell death-1/programmed death-ligand 1(PD-1/PD-L1)inhibitors combined with chemotherapy in curing breast cancer is still controversial,this meta-analysis compares the efficacy and safety of PD-1/PD-L1 inhibitors combined with chemotherapy and chemotherapy alone in the treatment of breast cancer,which provides guidance for the clinical treatment.Methods:Relevant studies published as of April 2022 in the various databases including EMBASE,PubMed,and Cochrane Library were selected.Randomized controlled trials(RCTs)in which control patients underwent chemotherapy alone and experimental group patients underwent combination chemotherapy and PD-1/PD-L1 inhibitor treatment were included in this investigation.Investigations without complete information,researches from which information could not be extracted,duplicate articles,animal studies,review articles,and systematic reviews were excluded.STATA 15.1 was employed for all statistical analyses.Results:In total,eight eligible studies were identified,revealing that combination chemotherapy and PD-1/PD-L1 inhibitor treatment was linked to significant increases in progression-free survival(PFS)relative to chemotherapy alone(hazard ratio[HR]=0.83,95%confidence interval[CI]:0.70–0.99,P=0.032)but not overall survival(HR=0.92,95%CI:0.80–1.06,P=0.273).Pooled adverse event rates were also increased within the group of combination treatment relative to the chemotherapy group(risk ratio[RR]=1.08,95%CI:1.03–1.14,P=0.002).Specifically,nausea rates were lesser within the group of combination treatment relative to the group of chemotherapy(RR=0.48,95%CI:0.25–0.92,P=0.026).Subgroup analyses indicated that the PFS of patients who underwent combination atezolizumab or pembrolizumab and chemotherapy treatment were substantially longer than those of patients who underwent chemotherapy alone(HR=0.79,95%CI:0.69–0.89,P≤0.001;HR=0.79,95%CI:0.67–0.92,P=0.002).Conclusions:The pooled results suggest that combination chemotherapy and PD-1/PD-L1 inhibitor treatment approaches help prolong PFS in breast cancer patients,but have no statistically significant effect on overall survival(OS).Additionally,combination therapy can significantly improve complete response rate(CRR)compared with chemotherapy alone.However,combination therapy was associated with greater rates of adverse events.展开更多
目的探讨胃腺癌组织中程序性细胞死亡配体1(programmed cell death ligand-1,PD-L1)4种克隆号抗体免疫组化(IHC)检测的一致性。方法对286例胃腺癌手术样本组织芯片(tissue microarray,TMA)进行PD-L122C3、SP263、E1L3N和SP1424种克隆号...目的探讨胃腺癌组织中程序性细胞死亡配体1(programmed cell death ligand-1,PD-L1)4种克隆号抗体免疫组化(IHC)检测的一致性。方法对286例胃腺癌手术样本组织芯片(tissue microarray,TMA)进行PD-L122C3、SP263、E1L3N和SP1424种克隆号抗体染色,采用肿瘤细胞比例评分(TPS)和联合阳性评分(CPS)标准,在不同临界值下对抗体的一致性进行统计学分析。结果22C3在4种克隆号抗体TPS(临界值1%、5%、10%)和CPS(临界值1、5、10)评估下的阳性率均最高。一致性分析显示,仅在CPS阳性临界值为1时,E1L3N与SP142(κ=0.612)和SP263(κ=0.660)的一致性较好,其余情况下各抗体之间具有中等或以下的一致性。结论PD-L14种克隆号抗体在不同TPS和CPS阳性临界值下的一致性不佳,在胃腺癌临床检测时不建议互换试剂,应按照规范描述检测结果。展开更多
文摘With the wide application of immunotherapy drug PD-1/PD-L1 inhibitor in China and the continuous clinical research,a major problem that we have to face is the immune-related pneumonia caused by PD-1/PD-L1.At present,western medicine mainly treated it by hormone therapy,which may cause side effects,such as obesity,osteoporosis and osteonecrosis for hormone therapy by long-term,and increase the patients'pain.Under the guidance of the theory of syndrome differentiation,traditional Chinese medicine(TCM)advocates the methods of expelling wind and clearing away cold,resolving phlegm and relieving asthma,relieving heat from lung,and invigorating the spleen and tonifying the kidney,etc.Exact differentiation of symptoms and rational usage of drugs can play an important role in the early prevention and treatment of immune-related pneumonia,reflecting the important role of TCM in the prevention and treatment of side effects of new drugs.In order to provide an effective clinical reference for clinicians in the practice of using PD-1/PD-L1,this paper systematically reviewed the use of TCM in the treatment of immune-related pneumonia induced by PD-1/PD-L1 inhibitors.
文摘Objective To explore the benefits and risks of PD-1/PD-L1 inhibitors Atezolizumab and Nivolumab in the treatment of non-squamous non-small cell lung cancer and provide some references for clinicians.Methods Based on the data results of relevant studies published by ClinicalTrical.gov in the US clinical trial database and foreign peer-reviewed journals,the internationally recognized multi-criteria decision analysis(MCDA)model was used to assess the benefit and risk of PD-1/PD-L1 inhibitors for non-squamous non-small lung cancer comprehensively.Finally,a sensitivity analysis was performed to test the sensitivity of the weight to the evaluation.Results and Conclusion The benefit-risk evaluation result of Atezolizumab for the treatment of non-squamous non-small cell lung cancer is better than that of Nivolumab.Specifically,Atezolizumab has more benefits than Nivolumab with a lower risk.The results of MCDA model in drug benefit and risk evaluation are easy to understand.However,the selection of indicators in the model and the degree of data acquisition are limited.The evaluation results of the MCDA model should be comprehensively viewed with other evaluations to make decisions objectively.
文摘目的探讨肉瘤样肾细胞癌组织中PD-L1的表达及肿瘤内微血管密度情况,为肉瘤样肾细胞癌免疫治疗及靶向治疗方案的选择提供理论依据。方法通过免疫组化法检测PD-L1、CD31及CD34在16例肉瘤样肾细胞癌(癌成分均为透明细胞肾细胞癌)中的表达,并评估肿瘤微血管密度。结果16例肿瘤中CD31和CD34免疫组化染色显示,肉瘤样肾细胞癌区域微血管密度明显高于不伴肉瘤样分化的区域,微血管密度计数分别为68.6±25.8 vs 38.7±16.0(t=3.931,P=0.0005)和69.5±28.1 vs 40.1±18.4(t=3.506,P=0.0015),差异有统计学意义。肉瘤样区域PD-L1表达水平高于非肉瘤样区域,CPS分别为34.7±26.9和25.9±27.6,但差异无统计学意义。结论在肉瘤样肾细胞癌中,肉瘤样区域微血管密度和PD-L1表达水平明显高于非肉瘤样区域,提示靶向治疗联合免疫治疗可能为此类肿瘤提供一种有效的治疗方法。
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。
基金supported by a grant from the Suzhou Youth Science and Technology Program(No.KJXW2021067).
文摘Background:As the efficacy of programmed cell death-1/programmed death-ligand 1(PD-1/PD-L1)inhibitors combined with chemotherapy in curing breast cancer is still controversial,this meta-analysis compares the efficacy and safety of PD-1/PD-L1 inhibitors combined with chemotherapy and chemotherapy alone in the treatment of breast cancer,which provides guidance for the clinical treatment.Methods:Relevant studies published as of April 2022 in the various databases including EMBASE,PubMed,and Cochrane Library were selected.Randomized controlled trials(RCTs)in which control patients underwent chemotherapy alone and experimental group patients underwent combination chemotherapy and PD-1/PD-L1 inhibitor treatment were included in this investigation.Investigations without complete information,researches from which information could not be extracted,duplicate articles,animal studies,review articles,and systematic reviews were excluded.STATA 15.1 was employed for all statistical analyses.Results:In total,eight eligible studies were identified,revealing that combination chemotherapy and PD-1/PD-L1 inhibitor treatment was linked to significant increases in progression-free survival(PFS)relative to chemotherapy alone(hazard ratio[HR]=0.83,95%confidence interval[CI]:0.70–0.99,P=0.032)but not overall survival(HR=0.92,95%CI:0.80–1.06,P=0.273).Pooled adverse event rates were also increased within the group of combination treatment relative to the chemotherapy group(risk ratio[RR]=1.08,95%CI:1.03–1.14,P=0.002).Specifically,nausea rates were lesser within the group of combination treatment relative to the group of chemotherapy(RR=0.48,95%CI:0.25–0.92,P=0.026).Subgroup analyses indicated that the PFS of patients who underwent combination atezolizumab or pembrolizumab and chemotherapy treatment were substantially longer than those of patients who underwent chemotherapy alone(HR=0.79,95%CI:0.69–0.89,P≤0.001;HR=0.79,95%CI:0.67–0.92,P=0.002).Conclusions:The pooled results suggest that combination chemotherapy and PD-1/PD-L1 inhibitor treatment approaches help prolong PFS in breast cancer patients,but have no statistically significant effect on overall survival(OS).Additionally,combination therapy can significantly improve complete response rate(CRR)compared with chemotherapy alone.However,combination therapy was associated with greater rates of adverse events.
文摘目的探讨胃腺癌组织中程序性细胞死亡配体1(programmed cell death ligand-1,PD-L1)4种克隆号抗体免疫组化(IHC)检测的一致性。方法对286例胃腺癌手术样本组织芯片(tissue microarray,TMA)进行PD-L122C3、SP263、E1L3N和SP1424种克隆号抗体染色,采用肿瘤细胞比例评分(TPS)和联合阳性评分(CPS)标准,在不同临界值下对抗体的一致性进行统计学分析。结果22C3在4种克隆号抗体TPS(临界值1%、5%、10%)和CPS(临界值1、5、10)评估下的阳性率均最高。一致性分析显示,仅在CPS阳性临界值为1时,E1L3N与SP142(κ=0.612)和SP263(κ=0.660)的一致性较好,其余情况下各抗体之间具有中等或以下的一致性。结论PD-L14种克隆号抗体在不同TPS和CPS阳性临界值下的一致性不佳,在胃腺癌临床检测时不建议互换试剂,应按照规范描述检测结果。
