Tumor response as defined by iRECIST in gastrointestinal malignancies treated with PD-1 and PD-L1 inhibitors and correlation with survival.
Tumor response as defined by iRECIST in gastrointestinal malignancies treated with PD-1 and PD-L1 inhibitors and correlation with survival.
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iRECIST 定义的 PD-1 和 PD-L1 抑制剂治疗胃肠道恶性肿瘤中的肿瘤反应以及与生存的相关性
DOI：
10.1186/s12885-021-08944-9
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发表时间：
2021-11-19
期刊：
影响因子：
3.8
通讯作者：
Meng X
中科院分区：
文献类型：
--
作者：
Xie P;Zheng H;Chen H;Wei K;Pan X;Xu Q;Wang Y;Tang C;Gevaert O;Meng X
免疫检查点抑制剂治疗过程中的非典型肿瘤反应模式对免疫肿瘤学实践中的临床医生和研究人员提出了挑战。这项研究评估了肿瘤负荷动力学，以确定PD-1/PD-L1抑制剂治疗的晚期胃肠道恶性肿瘤的治疗反应和总生存期(OS)的成像生物标志物。这项回顾性研究纳入了2017年1月至2021年3月期间接受PD-1/PD-L1抑制剂治疗的75例晚期胃肠道恶性肿瘤患者的198个靶点。研究实体瘤免疫治疗反应评价标准(IRECIST)所定义的肿瘤直径变化，以确定治疗反应及其与OS的相关性。根据最佳总体疗效，肿瘤直径从− 100到+ 135.3%(中位数：− 9.6%)。总有效率为32.0%(24/75)，持续6个 月以上的疾病控制率为30.7%(23/75)，其中免疫完全缓解1例，免疫部分缓解20例，免疫稳定型2例。单因素分析显示，肿瘤直径较基线 <； 增加20%(48/75，64.0%)的患者的OS比≥增加20%(27/75，36.0%)的患者的OS时间更长(27/75，36.0%)，并且死亡风险降低(中位数OS：80 月对48 月，HR = 0.22，P = 0.034)。年龄(HR = 1.0 9，P = 0.0 1)、联合手术(HR = 0.15，P = 0.0 1)、肿瘤类型(HR = 0.2 3，P = 0.001)差异有统计学意义。在多变量分析中，肿瘤直径 <； 增加20%的患者在调整了年龄、联合手术、KRAS状态、癌症类型、错配修复状态、疗程和癌症分化后，死亡风险显著降低(HR = 0.15，P = 0.01)。2例(2.7%)出现假性进展。肿瘤直径在治疗期间 <； 较治疗前增加20%与治疗效果和较长的OS有关，可作为治疗反应、临床结果和治疗决策的实用影像标记物。网上版载有补充材料，可在10.1186/s12885-021-08944-9查阅。
Atypical tumor response patterns during immune checkpoint inhibitor therapy pose a challenge to clinicians and investigators in immuno-oncology practice. This study evaluated tumor burden dynamics to identify imaging biomarkers for treatment response and overall survival (OS) in advanced gastrointestinal malignancies treated with PD-1/PD-L1 inhibitors. This retrospective study enrolled a total of 198 target lesions in 75 patients with advanced gastrointestinal malignancies treated with PD-1/PD-L1 inhibitors between January 2017 and March 2021. Tumor diameter changes as defined by immunotherapy Response Evaluation Criteria in Solid Tumors (iRECIST) were studied to determine treatment response and association with OS. Based on the best overall response, the tumor diameter ranged from − 100 to + 135.3% (median: − 9.6%). The overall response rate was 32.0% (24/75), and the rate of durable disease control for at least 6 months was 30.7% (23/75, one (iCR, immune complete response) or 20 iPR (immune partial response), or 2iSD (immune stable disease). Using univariate analysis, patients with a tumor diameter maintaining a < 20% increase (48/75, 64.0%) from baseline had longer OS than those with ≥20% increase (27/75, 36.0%) and, a reduced risk of death (median OS: 80 months vs. 48 months, HR = 0.22, P = 0.034). The differences in age (HR = 1.09, P = 0.01), combined surgery (HR = 0.15, P = 0.01) and cancer type (HR = 0.23, P = 0.001) were significant. In multivariable analysis, patients with a tumor diameter with a < 20% increase had notably reduced hazards of death (HR = 0.15, P = 0.01) after adjusting for age, combined surgery, KRAS status, cancer type, mismatch repair (MMR) status, treatment course and cancer differentiation. Two patients (2.7%) showed pseudoprogression. Tumor diameter with a < 20% increase from baseline during therapy in gastrointestinal malignancies was associated with therapeutic benefit and longer OS and may serve as a practical imaging marker for treatment response, clinical outcome and treatment decision making. The online version contains supplementary material available at 10.1186/s12885-021-08944-9.
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影响因子：
8.4
作者：
Eisenhauer, E. A.;Therasse, P.;Verweij, J.
通讯作者：
Verweij, J.
DOI：
10.1038/nrclinonc.2017.88
发表时间：
2017-11
期刊：
Nature reviews. Clinical oncology
影响因子：
--
作者：
Nishino M;Ramaiya NH;Hatabu H;Hodi FS
通讯作者：
Hodi FS
影响因子：
8.4
作者：
Tazdait, M.;Mezquita, L.;Caramella, C.
通讯作者：
Caramella, C.
影响因子：
20.4
作者：
Fujimoto, Daichi;Yoshioka, Hiroshige;Hirai, Toyohiro
通讯作者：
Hirai, Toyohiro
影响因子：
3.4
作者：
Lee JS;Choi HJ;Kim BK;Park JY;Kim DY;Ahn SH;Han KH;Baek SE;Chung YE;Park MS;Kim MJ;Rhee H;Kim SU
通讯作者：
Kim SU