[1]赵先兰,李吉茜,杨峤,等.非小细胞肺癌免疫治疗抗药物抗体对临床疗效及不良反应的影响[J].第三军医大学学报,2021,43(17):1673-1678.
 ZHAO Xianlan,LI Jixi,YANG Qiao,et al.Effects of anti-drug antibody on clinical efficacy and adverse reactions of immunotherapy for non-small cell lung cancer[J].J Third Mil Med Univ,2021,43(17):1673-1678.
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非小细胞肺癌免疫治疗抗药物抗体对临床疗效及不良反应的影响(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
43卷
期数:
2021年第17期
页码:
1673-1678
栏目:
临床医学
出版日期:
2021-09-15

文章信息/Info

Title:
Effects of anti-drug antibody on clinical efficacy and adverse reactions of immunotherapy for non-small cell lung cancer
作者:
赵先兰李吉茜杨峤李世勋余永新李奉李梦侠孙建国
陆军军医大学(第三军医大学)第二附属医院肿瘤科;解放军第941医院超声诊断科;陆军特色医学中心肿瘤科
Author(s):
ZHAO Xianlan LI Jixi YANG Qiao LI Shixun YU Yongxin LI Feng LI Mengxia SUN Jianguo

Department of Oncology, Second Affiliated Hospital, Army Medical University (Third Military Medial University), Chongqing, 400037; 2Department of Ultrasonography, No. 941 Hospital of PLA Joint Logistic Support Force, Xining, Qinghai Province, 810007; 3Department of Oncology, Daping Hospital, Army Medical University (Third Military Medial University), Chongqing, 400037, China

关键词:
非小细胞肺癌抗药物抗体免疫检查点抑制剂免疫相关不良反应
Keywords:
non-small cell lung cancer anti-drug antibody immune checkpoint inhibitors immune-related adverse events
分类号:
R446.62; R730.53; R734.2
文献标志码:
A
摘要:

目的探索非小细胞肺癌(non-small cell lung cancer, NSCLC)患者接受免疫检查点抑制剂(immune checkpoint inhibitors, ICIs)治疗后产生的抗药物抗体(anti-drug antibody,ADA)对患者临床疗效及不良反应的影响。方法从陆军军医大学第二附属医院及陆军特色医疗中心收集2016年4月至2019年9月使用帕博利珠单抗或纳武利尤单抗的Ⅲ/Ⅳ期NSCLC患者共26例,在首次输注后2个月左右采集血样,使用酶联免疫法检测血浆中ADA水平,并分析ADA对ICIs的临床疗效、疾病进展及免疫相关不良反应(immune-related adverse events, irAEs)的影响。结果12例接受纳武利尤单抗治疗的患者,ADA检测结果均为阴性,最佳总体反应率(best overall response, bOR)为25.0%,中位无进展生存期(median progression-free survival, mPFS)为4.1(1.9~26.9)个月,中位总生存期(median overall survival, mOS)为12.4个(4.8~26.9)月。14例接受帕博利珠单抗治疗的患者,bOR为50.0%,mPFS为10.9(2.2~15.3)个月,mOS为19.0(3.5~29.6)个月;其中3例ADA阳性,11例ADA阴性,ADA阳性患者的mPFS(9.9 vs 12.4个月,P=0.280)、mOS(19.0 vs 29.6个月,P=0.874)以及采血后至出现影像进展的中位时间(7.5 vs 8.6个月,P=0.365)均短于ADA阴性患者;ADA阳性和阴性患者2级以上irAEs的发生率分别为66.7%和23.7%。结论ADA监测对于接受ICIs治疗的NSCLC患者有一定临床价值。帕博利珠单抗ADA阳性患者生存时间较短,但ADA状态对其bOR和irAEs的影响不显著。

Abstract:

ObjectiveTo explore the effects of anti-drug antibody (ADA) on clinical efficacy and adverse reactions in patients with non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICIs). MethodsA total of 26 patients with stage Ⅲ/Ⅳ NSCLC undergoing pembrolizumab or nivolumab treatment from April 2016 to September 2019 were collected from the Second Affiliated Hospital and Daping Hospital of Army Medical University. Blood samples were collected about 2 months after the first infusion of ICIs. The level of ADA in plasma were measured by enzyme-linked immunosorbent assay. The effects of ADA on the clinical efficacy, disease progression and immune-related adverse events (irAEs) of ICIs were analyzed. ResultsIn 12 patients treated with nivolumab, the results of ADA test were negative, the best overall response rate (bOR) was 25.0%, the median progression-free survival (mPFS) was 4.1(1.9~26.9) months, and the median overall survival (mOS) was 12.4 (4.8~26.9) months. In 14 patients treated with pembrolizumab, bOR was 50.0%, mPFS was 10.9 (2.2~25.3) months, and mOS was 19.0 (5.2~29.6) months; 3 of 14 patients were ADA-positive, 11 were ADA-negative. mPFS (9.9 vs 12.4 months, P=0.280), mOS (19.0 vs 29.6 months, P=0.874) and median time to radiographic progression after blood sampling (7.5 vs 8.6 months, P=0.365) were significantly shorter in the ADA-positive patients than the ADA-negative patients. irAEs occurred in 2 (66.7%) ADA positive patients and 3 (27.3%) ADA negative patients. ConclusionADA monitoring in NSCLC patients has certain clinical value for the treatment of ICIs, and ADA positive of pembrolizumab has an effect on the shorter survival time of patients. However, the effect of ADA status is not significant on bOR and irAEs.

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更新日期/Last Update: 2021-09-03