CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Prospective study of adoptive activated αβT lymphocyte immunotherapy for refractory cancers: development and validation of a response scoring system.
Prospective study of adoptive activated αβT lymphocyte immunotherapy for refractory cancers: development and validation of a response scoring system.
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过继性活化αβT 淋巴细胞免疫治疗对某些患者具有临床疗效。作者的评分系统是首个针对该疗法报道的预后模型,有助于筛选可能通过该方式获得更好预后的患者。
这项前瞻性临床研究旨在确定过继性活化αβT淋巴细胞免疫治疗对多种难治性癌症的疗效和预后因素。主要终点为总生存期(OS),次要终点为影像学缓解。
作者治疗了96例患者。活化的αβT淋巴细胞每2周输注一次,共6次。通过分析治疗前获得的临床和实验室数据,确定了预后因素。
中位生存期(MST)为150天(95%置信区间,105-191),约20%的患者实现了疾病控制(完全缓解+部分缓解+疾病稳定)。根据采用Akaike信息准则最佳子集选择的多因素Cox比例风险模型,性别、同步治疗、中性粒细胞/淋巴细胞比值、白蛋白、乳酸脱氢酶、CD4:CD8比值和辅助性T细胞(Th)1:Th2比值是强预后因素。利用Cox分析的参数估计,作者开发了一个反应评分系统。作者随后确定了反应者与非反应者之间反应评分的阈值。该阈值能够显著区分反应者与非反应者的OS。反应者的MST长于非反应者(317.5天对74天)。该反应评分系统的有效性随后通过内部验证得到确认。
The authors treated 96 patients. Activated αβT lymphocytes were infused every 2 weeks for a total of six times. Prognostic factors were identified by analyzing clinical and laboratory data obtained before therapy.
Median survival time (MST) was 150 days (95% confidence interval, 105-191), and approximately 20% of patients achieved disease control (complete response + partial response + stable disease). According to the multivariate Cox proportional hazards model with Akaike information criterion-best subset selection, sex, concurrent therapy, neutrophil/lymphocyte ratio, albumin, lactate dehydrogenase, CD4:CD8 ratio and T helper (Th)1:Th2 ratio were strong prognostic factors. Using parameter estimates of the Cox analysis, the authors developed a response scoring system. The authors then determined the threshold of the response score between responders and non-responders. This threshold was able to significantly differentiate OS of responders from that of non-responders. MST of responders was longer than that of non-responders (317.5 days versus 74 days). The validity of this response scoring system was then confirmed by internal validation.
Adoptive activated αβT lymphocyte immunotherapy has clinical efficacy in certain patients. The authors' scoring system is the first prognostic model reported for this therapy, and it is useful for selecting patients who might obtain a better prognosis through this modality.
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