Ⅳ期、不可手术和复发性胃癌一线治疗方案
权威癌症研究机构美国国家癌症研究所 (NCI)对Ⅳ期、不可手术和复发性胃癌的一线治疗方案:姑息性全身治疗-免疫联合化疗疗法(派姆单抗联合化疗)。
派姆单抗联合化疗治疗Ⅳ期期、不可手术和复发性胃癌医学证据
一项 III 期、部分盲法、随机、国际研究 ( KEYNOTE -062 [NCT02494583])[1],纳入了 763 名既往未治疗的晚期胃癌患者,PD-L1 CPS ≥1 名患者以 1:1:1 的比例随机分配接受派姆单抗 200 mg 静脉注射(IV) 每 3 周,Pembrolizumab(派姆单抗)联合化疗(顺铂联合 5-FU 或卡培他滨),或单独化疗。 [2]
1.最终结果并未显示 Pembrolizumab(派姆单抗)或Pembrolizumab(派姆单抗)联合化疗优于单独化疗。
2.However, when selected for PD-L1 CPS ≥10, median OS was 17.4 months (95% CI, 9.1−23.1) in the Pembrolizumab-alone arm compared with 10.8 months (95% CI, 8.5−13.8) in the chemotherapy-alone手臂(HR,0.69;95% CI,0.49-0.97)。预先指定的统计分析计划没有进一步测试这种差异。
参考资料:
[1]Study of Pembrolizumab (MK-3475) as First-Line Monotherapy and Combination Therapy for Treatment of Advanced Gastric or Gastroesophageal Junction Adenocarcinoma (MK-3475-062 / KEYNOTE-062)[NCT02494583].
[2]Moehler M, Shitara K, Garrido M, et al.: Nivolumab (nivo) plus chemotherapy (chemo) versus chemo as first-line (1L) treatment for advanced gastric cancer/gastroesophageal junction cancer (GC/GEJC)/esophageal adenocarcinoma (EAC): First results of the CheckMate 649 study. [Abstract] Ann Oncol 31 (Suppl 4): A-LBA6_PR, 2020.