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Efficacy of Cytotoxic Agents After Progression on Anti-PD-(L)1 Antibody for Pre-treated Metastatic Gastric Cancer.

细胞毒性药物对治疗前转移性胃癌的抗 PD-(L)1 抗体进展后的疗效。

  • 影响因子:1.90
  • DOI:10.21873/anticanres.14187
  • 作者列表:"Kato K","Narita Y","Mitani S","Honda K","Masuishi T","Taniguchi H","Kadowaki S","Ura T","Ando M","Tajika M","Muro K
  • 发表时间:2020-04-01
Abstract

BACKGROUND/AIM:The efficacy of treatment using the anti-programmed cell death-1 (anti-PD-1) antibody for metastatic gastric cancer (mGC) has been established previously. Exploratory analyses in various types of tumours suggest that prior exposure to immune checkpoint inhibitors can enhance the efficacy of subsequent cytotoxic chemotherapy (CTx). Our aim is to evaluate the efficacy and safety of CTx for mGC after progression on anti-PD-(ligand) 1 [anti-PD-(L)1] antibody. PATIENTS AND METHODS:We retrospectively evaluated patients with mGC who underwent CTx. The patients received CTx after progression on anti-PD-(L)1 antibody (cohort A) or as a third-line treatment without prior exposure to anti-PD-(L)1 antibody (cohort B). We evaluated: i) clinical characteristics, ii) efficacies, iii) prognoses, and iv) adverse events (AEs). RESULTS:In cohorts A and B, 16 and 68 patients fulfilled the criteria, respectively. In the univariate analysis, the overall response rate was significantly higher in cohort A compared to cohort B (31% vs. 10%, respectively; Odds Ratio:3.96, 95% Confidence Interval:1.06-14.8, p=0.040). The multivariate analysis showed a similar trend. Immune-related AEs did not worsen and were manageable, while new immune-related AEs were not observed. CONCLUSION:CTx after progression on anti-PD-(L)1 antibody demonstrated a favourable efficacy in intensively treated patients with mGC.

摘要

背景/目的: 抗程序性细胞死亡-1 (anti-PD-1) 抗体治疗转移性胃癌 (mGC) 的疗效已被证实。各种类型肿瘤的探索性分析表明,事先暴露于免疫检查点抑制剂可以增强后续细胞毒性化疗 (CTx) 的疗效。我们的目的是评价 CTx 对抗 PD-(配体) 1 [抗 PD-(L)1] 抗体进展后 mGC 的疗效和安全性。 患者和方法: 我们回顾性评估了接受 CTx 的 mGC 患者。患者在抗 PD-(L)1 抗体进展后接受 CTx 治疗 (队列 A) 或作为三线治疗,既往未暴露于抗 PD-(L)1 抗体 (队列 B)。我们评价了: i) 临床特征,ii) 疗效,iii) 预后,iv) 不良事件 (AEs)。 结果: 在队列 A 和 B 中,分别有 16 例和 68 例患者符合标准。在单变量分析中,队列 A 的总体缓解率显著高于队列 B (31% vs.分别为 10%; 比值比: 3.96,95% 可信区间: 1.06-14.8,p = 0.040)。多变量分析显示了类似的趋势。免疫相关的 AEs 没有恶化,并且是可控的,而没有观察到新的免疫相关的 AEs。 结论: 抗 PD-(L)1 抗体进展后的 CTx 对 mGC 强化治疗患者显示出良好的疗效。

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