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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 | Emergy evaluation of the performance and sustainability of three agricultural systems with different scales and management显示文摘 | Martin J F Diemont S A W Powell E Stanton M Levy-Tacher S | 2006 | Agriculture Ecosystems&Environment2006，115，14： | 1 |
| 3 | Two new forms of gonadotropin-releasing hormone in a protochordate and the evolutionary implications显示文摘 | Powell J F Reska-Skiuner S M Prakash M O | | 0，，： | 1 |
| 4 | Phosphomannose isomerase:an efficient selectable marker for plant transformation显示文摘 | Reed J Privallel L Powell M L Meghji M Dawson J Dunder E Suttie J Wenck A Launis K Kramer C Chang Y F Hansen G Wright M | | 0，，： | 1 |
| 5 | Recombinant soluble human Fc gamma R production,characterization,and inhibition of the Arthus reaction显示文摘 | IERINO F L POWELL M S MCKENIE I F | 1993 | J Exp Med1993，178，12： | 1 |
| 6 | Primary structure and function of three gonadotropin-releasing hormones, including a novel form, from an ancient teleost, herring显示文摘 | Carolsfeld J Powell J F Park M | 2000 | Endocrinology2000，141，2： | 1 |
| 7 | Nocturnal 02 onrichment of room air at high altitude increases daytime 02 Saturation without changing control of ventilation显示文摘 | Gerard A Powell F L | 2000 | High Alt Med Biol2000，1，3： | 1 |
| 8 | Vali- dation of feed and manure data collected on Wisconsin dairy farms显示文摘 | Powell J M Jackson-Smith D B McCrory D F | 2006 | JDairySci2006，89，6： | 1 |
| 9 | Pulmonary artery sling with unresponsive hypercarbia necessitating extracorporeal membrane oxygenation support显示文摘 | Ades A M Powell D Midgely F | 2001 | Pediatr Cardiol2001，22，5： | 1 |
| 10 | Hurricane hazard modeling: the past, present, and future 显示文摘 | Vickery P J Masters F J Powell M D | 2009 | Journal of Wind Engineering and Industrial Aerodynamics2009，97，78： | 1 |
| 11 | Vegetative compatibility and seasonal variation among isolates of Sclerotinia homoeocarpa 显示文摘 | Powell J F Vargas J M Jr | 2001 | Plant Disease2001，85，4： | 1 |
| 12 | Hypermethylation of metallothionein-3 CpG island in gastric carcinoma显示文摘 | Deng D El-Rifai W Ji J Zhu B Trampont P Li J Smith M F Powel S M | | 0，，01： | 1 |
| 13 | Micropropagation of American chestnut: increasing rootind and preventing shoot-tip necrosis显示文摘 | Xing Z Satchwell M F Powell W A | 1997 | In Vitro Cell Dev Biol Plant1997，33，： | 1 |
| 14 | Pulmonary artery sling with unresponsive hypercarbia necessitating extracorporeal membrane oxygenation support 显示文摘 | Ades A M Powell D Midgely F | 2001 | Pediatr Cardiol2001，22，5： | 1 |
| 15 | Validation of feed and manure data collected on wisconsin dairy farms显示文摘 | Powell J M Jackson-Smith D B Mccrory D F | 2006 | Journal of Dairy Science2006，89，6： | 1 |
| 16 | Respiratory and acid-base pathophysiology of hydrogen peroxide in rainbow trout (Oncorhynchus mykiss Walbaum) 显示文摘 | Powell M D Perry S F | 1997 | Aquatic Toxicology1997，37，23： | 1 |
| 17 | Food prices and obesity:evidence and policy implications for taxes and subsidies 显示文摘 | POWELL L M CHALOUPKA F J | 2009 | Milbank Quarterly2009，87，1： | 1 |
| 18 | A CFD simulation of a single phase hydrocyclone flow field显示文摘 | Dlamini M F Powell M S Meyer C J | 2005 | The South African insti- tute of mining and metallurgy2005，105，10： | 1 |
| 19 | Large-scale molecular and tissue microarray analysis of mesothelin expression in common human carcinomas显示文摘 | Frierson H F Jr Moskaluk C A Powell S M | 2003 | Hum Pathol2003，34，： | 1 |
| 20 | The development of stable protein formulations:a close look at protein aggregation,deamidation,and oxidation显示文摘 | CLELAND J L POWELL M F SHIRE S J | 1993 | Crit Rev Ther Drug Carrier Syst1993，10，4： | 1 |
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