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PD-1 抑制剂单药或联合化疗治疗复发/难治性结外自然杀伤/T 细胞淋巴瘤的疗效与安全性:一项回顾性研究

英文原题:Efficacy and safety of PD-1 inhibitor alone or combined with chemotherapy in patients with relapsed or refractory extranodal natural Killer/T cell lymphoma: A retrospective study.

查看英文原题

Efficacy and safety of PD-1 inhibitor alone or combined with chemotherapy in patients with relapsed or refractory extranodal natural Killer/T cell lymphoma: A retrospective study.

PubMed 2022/12/30(内容时间) Hematol Oncol Q1 · IF 4.1(JCR 2025)

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中文摘要

复发或进展后,结外自然杀伤/T细胞淋巴瘤(ENKTL)患者接受含天冬酰胺酶化疗通常预后不佳。目前,程序性细胞死亡蛋白1(PD-1)免疫检查点阻断已显示出良好疗效,可能成为复发/难治性ENKTL(rrENKTL)的优选方案。

本研究回顾性分析2018年1月至2022年2月期间26例rrENKTL患者接受PD-1单克隆抗体(信迪利单抗或卡瑞利珠单抗)单药或联合化疗的疗效、安全性及影响生存的因素。疾病控制率为73.1%,客观缓解率为50.0%;完全缓解率为15.4%,部分缓解率为34.6%。中位随访12个月(范围3–47个月)后,无进展生存期(PFS)和总生存期(OS)中位数分别为6.5个月和13.3个月;1年PFS率和OS率分别为23.1%和53.8%。96.2%的患者至少发生一种不良事件,26.9%发生1–2级免疫相关不良事件。PD-1抑制剂改善了rrENKTL患者生存,且不良事件可控。研究还发现,包含EB病毒(EBV)状态的NK细胞淋巴瘤预后指数(PINK-E)以及ENKTL患者列线图修订风险指数,有助于在免疫治疗时代识别潜在预后不良患者。抗PD-1治疗后应特别关注EBV状态,因为它能更准确提示预后不良。

展开英文摘要原文

Extranodal natural killer/T cell lymphoma (ENKTL) patients typically face a grim prognosis after relapse or progression following asparaginase-based chemotherapy. Currently, programmed cell death protein-1 (PD-1) immune checkpoint blockade has shown promising efficacy as an optimal regimen for relapsed or refractory ENKTL (rrENKTL) patients.

This study retrospectively investigated the efficacy, safety, and factors influencing the survival of 26 rrENKTL patients who underwent monoclonal antibody treatment using PD-1 (Sintilimab or Camrelizumab) alone or combined with chemotherapy from January 2018 to February 2022. The disease control rate was 73. 1%, and the objective response rate was 50. 0%. 15. 4% of the patients achieved complete remission, and 34.

6% achieved partial remission (PR). After a median follow-up of 12 (range 3-47) months, the median progression-free survival (PFS) and overall survival (OS) were 6. 5 and 13. 3 months. The 1-year PFS and OS rate were 23. 1% and 53. 8%. 96. 2% of patients experienced at least one adverse event and 26. 9% experienced grade 1-2 immune-related adverse events. PD-1 inhibitor improved rrENKTL patient survival, and the AEs were controlled.

We also observed that the prognostic index for NK cell lymphoma including Epstein-Barr virus (EBV) (PINK-E) and the nomogram-revised risk indexz for ENKTL patients could help identify a potentially unfavorable prognosis in this era of immunotherapy. More attention should be paid to the presence of EBV after anti-PD-1 immunotherapy, as it more accurately indicates a poor prognosis.

论文信息

作者
Tian J、Hao M、Liu Q、Xiao F、Li Y、Qi M、Gao J、Liu L
单位
Department of Hematology, Tangdu Hospital, Fourth Military Medical University (Air Force Medical University), Xi'an, China.China
期刊
Hematological oncology2023 Aug
原文标识
PubMed 36516297 · DOI 10.1002/hon.3116