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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 | Coupled finite-element codes for armature design显示文摘 | NEWILL J F POWELL J D ZIELINSKI A E | 2003 | IEEE Transac- tions on Magneties2003，39，1： | 1 |
| 3 | 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 |
| 4 | Influence of LCF overloads on combined HCF/LCF crack growth 显示文摘 | Byrne J Hall R F Powell B E | 2003 | International Journal of Fatigue2003，25，911： | 1 |
| 5 | Comparison of electron elastic-scattering cross sections calculated from two commonly used atomic potentials显示文摘 | JABLONSKI A SALVAT F POWELL C J | 2004 | J Phys Chem Ref Data2004，33，2： | 1 |
| 6 | 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 |
| 7 | 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 |
| 8 | 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 |
| 9 | A ray tracing analysis of the absorption of light by smooth and rough metal surfaces显示文摘 | Bergstrom D Powell J Kaplan A F H | 2007 | Journalof Applied Physics2007，101，11： | 1 |
| 10 | Specular electron scattering in giant magnetoresistance spin valves 显示文摘 | EGELHOFF W F CHEN P J POWELL C J | 1997 | IEEE Transactions on Magnetics1997，33，： | 1 |
| 11 | The lateral organ boundaries domain transcription factor LBD20 functions in fu- sarium wilt susceptibility and jasmonate signaling in Arabidopsis显示文摘 | THATCHER L F POWELL J J AITKEN E A | 2012 | Plant Physiology2012，160，1： | 1 |
| 12 | 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 |
| 13 | Observer-based air fuel ratio control显示文摘 | Powell J D Fekete N P Change C F | 1998 | IEEE Control Syst1998，18，5： | 1 |
| 14 | Systematics of the Argyrotaenia franciscana ( Lepidoptera: Tortricidae) species group: evidence from mitochondrial DNA 显示文摘 | LANDRY B POWELL J A SPERLING F A H | 1999 | Annals of the Entomological Society of America1999，92，： | 1 |
| 15 | 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 |
| 16 | FTO gen-otype is associated with phenotypic variability of body mass index 显示文摘 | YANG J LOOS R J F POWELL J E | 2012 | Nature2012，490，： | 1 |
| 17 | Optimizing the Gi-ant Magnetoresistance of Symmetric and Bottom Spin Valves显示文摘 | Egelhoff W F Chen P J Powell C J | 1996 | Journal of Applied Physics1996，79，8： | 1 |
| 18 | Childhood vulvar lichen sclerosus:an increasingly common problem显示文摘 | Powell J J Wojna rowska F | 2001 | J Am Acad Dermatol2001，44，3： | 1 |
| 19 | An analytical thermodynamic model of laser welding显示文摘 | Lampa A F H Kaplan J Powell | 1997 | J Phys D:Appl Phys1997，30，9： | 1 |
| 20 | 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 |
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