Considerations for treatment duration in responders to immune checkpoint inhibitors.
Considerations for treatment duration in responders to immune checkpoint inhibitors.
复制标题
DOI：
10.1136/jitc-2020-001901
复制
发表时间：
2021-03
影响因子：
10.9
通讯作者：
Guerriero JL
中科院分区：
文献类型：
--
作者：
Marron TU;Ryan AE;Reddy SM;Kaczanowska S;Younis RH;Thakkar D;Zhang J;Bartkowiak T;Howard R;Anderson KG;Olson D;Naqash AR;Patel RB;Sachdev E;Rodriguez-Ruiz ME;Sheffer M;Church S;Fuhrman C;Overacre-Delgoffe A;Nguyen R;Florou V;Thaxton JE;Aggen DH;Guerriero JL
免疫检查点抑制剂(ICIS)已经提高了癌症患者的总存活率，然而，ICI治疗的最佳持续时间尚未确定。鉴于ICIS最初用于治疗转移性黑色素瘤患者，这种疾病在当时是无法治愈的，最初几乎没有人注意到需要多少治疗才能获得持久的反应。由于早期免疫疗法试验在过去10年中已经成熟，有相当大一部分患者表现出持久的反应；现在是时候确定患者是否被过度治疗了，以及是否仍然可以用较少的治疗来实现持久缓解，从而限制与多年治疗相关的身体和经济毒性。需要设计良好的试验来确定最佳治疗时间，并定义生物标记物来预测谁将受益于较短的免疫治疗疗程。在这里，我们概述了与ICI过度治疗的健康、经济和社会毒性相关的关键问题，并提出了四项独特的临床试验，旨在揭示ICI早期停止的标准。综上所述，过度治疗ICI患者有严重的责任，未来的工作是保证确定何时停止ICI是安全的。
Immune checkpoint inhibitors (ICIs) have improved overall survival for cancer patients, however, optimal duration of ICI therapy has yet to be defined. Given ICIs were first used to treat patients with metastatic melanoma, a condition that at the time was incurable, little attention was initially paid to how much therapy would be needed for a durable response. As the early immunotherapy trials have matured past 10 years, a significant per cent of patients have demonstrated durable responses; it is now time to determine whether patients have been overtreated, and if durable remissions can still be achieved with less therapy, limiting the physical and financial toxicity associated with years of treatment. Well-designed trials are needed to identify optimal duration of therapy, and to define biomarkers to predict who would benefit from shorter courses of immunotherapy. Here, we outline key questions related to health, financial and societal toxicities of over treating with ICI and present four unique clinical trials aimed at exposing criteria for early cessation of ICI. Taken together, there is a serious liability to overtreating patients with ICI and future work is warranted to determine when it is safe to stop ICI.
登录
查看更多内容
影响因子：
5.8
作者：
Khan, Shaheen;von Itzstein, Mitchell S.;Gerber, David E.
通讯作者：
Gerber, David E.
影响因子：
51.1
作者：
Powles, Thomas;Plimack, Elizabeth R.;Rini, Brian, I
通讯作者：
Rini, Brian, I
影响因子：
158.5
作者：
Larkin, J.;Chiarion-Sileni, V.;Wolchok, J. D.
通讯作者：
Wolchok, J. D.
影响因子：
2.2
作者：
Diamantopoulos, Panagiotis T.;Gaggadi, Maria;Gogas, Helen
通讯作者：
Gogas, Helen
影响因子：
45.3
作者：
Ascierto, Paolo A.;Minor, David;Trefzer, Uwe
通讯作者：
Trefzer, Uwe