RNF43 p.G659fs 通过 PI3K/AKT/mTOR 信号通路和 HLA-E 上调导致 MSI-high 结直肠癌中 NK 细胞功能障碍
RNF43 p.G659fs leads to natural killer cell dysfunction in MSI-high colorectal cancer through PI3K/AKT/mTOR signaling and HLA-E up-regulation.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Two-year efficacy of SNK01 plus pembrolizumab for non-small cell lung cancer: Expanded observations from a phase I/IIa randomized controlled trial.
Two-year efficacy of SNK01 plus pembrolizumab for non-small cell lung cancer: Expanded observations from a phase I/IIa randomized controlled trial.
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自体 NK 细胞可提高 NSCLC 的长期 OS 和 PFS。
既往一项试验显示,自体体外扩增 NK 细胞(SNK01)联合 pembrolizumab 治疗晚期非小细胞肺癌(NSCLC),疗效优于 pembrolizumab 单药。本研究对该试验进行 2 年随访,以评估联合治疗的长期疗效。
本试验纳入 20 例晚期 NSCLC 患者,其 PD-L1 肿瘤比例评分≥1%,且既往一线含铂治疗失败。患者接受 pembrolizumab 联合低剂量 SNK01(每剂 2×10⁹ 个细胞)、高剂量 SNK01(每剂 4×10⁹ 个细胞)或 pembrolizumab 单药治疗。主要研究终点为总生存期(OS),次要终点为无进展生存期(PFS)。
2 例患者因严重不良事件被排除。在 11 例死亡患者中,5 例来自 NK 细胞组(41.6%,n=5/12),6 例接受 pembrolizumab 单药(100%,n=6/6)。估计 2 年生存率在 pembrolizumab 联合 SNK01 组和 pembrolizumab 单药组分别为 58.3% 和 16.7%。联合组相较单药组的风险比为 0.32(95% CI:0.1–1.08,P=0.066)。尽管 pembrolizumab 联合 SNK01 组的中位 PFS 显著高于单药组,接受低剂量和高剂量 NK 细胞的患者在 OS 和 PFS 上均无统计学显著差异。
自体 NK 细胞可提高 NSCLC 患者的长期 OS 和 PFS;仍需更大规模研究确认这一结果。临床研究信息服务登记号:KCT0003463。
A previous trial showed that autologous ex-vivo expanded NK cell (SNK01) treatment combined with pembrolizumab showed better efficacy than pembrolizumab monotherapy in advanced non-small cell lung cancer (NSCLC). This study was a 2-year follow-up of that previous study to determine the long-term efficacy of the combination treatment.
This trial included 20 patients with advanced NSCLC with a PD-L1 tumor proportion score of 1% or greater who failed prior to front-line platinum-based therapy. The patients received pembrolizumab with low-dose SNK01 (2 10 9 cells/dose) or high-dose SNK01 (4 10 9 cells/dose), or pembrolizumab monotherapy. The primary study endpoint was overall survival (OS), and the secondary endpoint was progression-free survival (PFS).
Two patients were excluded following serious adverse events. Among the 11 patients who died, five were from the NK groups (41.6%, n = 5/12), and six received pembrolizumab monotherapy (100%, n = 6/6). The estimated 2-year survival rate was 58.3% versus 16.7% (pembrolizumab plus SNK01 vs. pembrolizumab monotherapy). The hazard ratio of pembrolizumab plus SNK01 compared with pembrolizumab monotherapy was 0.32 (95% CI: 0.1, 1.08, p-value: 0.066). Although the median PFS was significantly higher in the pembrolizumab plus SNK01 group than in the pembrolizumab alone group, OS and PFS did not differ statistically between patients who received low doses of NK cells and those who received high doses of NK cells.
Autologous NK cells can enhance the long-term OS and PFS for NSCLC. A larger study is needed to confirm this result. Clinical Research Information Service number: KCT0003463.
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