胰腺癌空间构型与新辅助治疗和根治性切除术后疾病复发相关
Spatial Configuration of Pancreatic Cancer Is Associated with Disease Recurrence after Neoadjuvant Therapy and Curative-Intent Resection.
从标准H&E切片量化的残留癌-间质拓扑结构在PDAC新辅助治疗后产生独立预后信号,为空间风险提供细胞免疫相关性依据,并推动前瞻性验证及空间信息指导的辅助治疗策略。
英文原题:Safety and Efficacy of CT041 in Patients With Refractory Metastatic Pancreatic Cancer: A Pooled Analysis of Two Early-Phase Trials.
Safety and Efficacy of CT041 in Patients With Refractory Metastatic Pancreatic Cancer: A Pooled Analysis of Two Early-Phase Trials.
在既往治疗进展后的转移性PC患者中,CT041显示出可耐受的安全性特征和令人鼓舞的抗肿瘤疗效信号。此处观察到的缓解获益有待未来进一步确认。
CT041是一种嵌合抗原受体(CAR)修饰的T细胞疗法,特异性靶向实体瘤中的claudin18.2。在此,我们报告两项探索性临床试验的汇总分析结果,以评估CT041在既往接受过治疗的胰腺癌(PC)患者中的疗效。
这两项多中心、开放标签的I/Ib期试验(CT041-CG4006、CT041-ST-01)具有相似的目标人群和评估计划。主要目的是评估CT041的安全性和耐受性,而次要目的包括疗效、药代动力学和免疫原性。
联合队列共纳入24例晚期PC患者。其中,5例患者(20.8%)既往接受过一线治疗,而19例(79.2%)接受过≥2线治疗。最常见的3级或以上治疗中出现的不良事件为预处理相关血液学毒性。细胞因子释放综合征(CRS)和GI疾病是报告最多的1级或2级不良事件。总缓解率和疾病控制率分别为16.7%和70.8%。输注后中位无进展生存期(mPFS)为3.3个月(95% CI,1.8至6.2),中位总生存期(mOS)为10.0个月(95% CI,5.5至17.6)。中位缓解持续时间(mDoR)为9.5个月(95% CI,2.6至未达到),12个月时DoR率为50%(95% CI,5.8至84.5)。达到部分缓解/疾病稳定的患者相比疾病进展组,mPFS(6.0 v 1.0个月,P < .001)和mOS(17.6 v 4.0个月,P < .001)均延长。17例(70.8%)患者的CA19-9水平至少降低了30%。
PURPOSE: CT041 is a chimeric antigen receptor (CAR)-modified T-cell therapy that specifically targets claudin18.2 in solid tumors. Here, we report the pooled analysis results of two exploratory clinical trials to evaluate CT041 in patients with previously treated pancreatic cancer (PC). PATIENTS AND METHODS: These two multicenter, open-label phase I/Ib trials (CT041-CG4006, CT041-ST-01) have a similar target population and evaluation schedule. The primary objective was to assess the safety and tolerability of CT041, whereas secondary objectives included efficacy, pharmacokinetics, and immunogenicity. RESULTS: The combined cohort comprised 24 patients with advanced PC. Among them, five patients (20.8%) had previously received one line of therapy, whereas 19 (79.2%) received ≥2 lines of therapy. The most common treatment-emergent adverse events of grade 3 or more were preconditioning-related hematologic toxicities. Cytokine release syndrome (CRS) and GI disorders were most reported grade 1 or 2 adverse events. The overall response rate and disease control rate were 16.7% and 70.8%. The median progression-free survival (mPFS) after infusion was 3.3 months (95% CI, 1.8 to 6.2), and the median overall survival (mOS) was 10.0 months (95% CI, 5.5 to 17.6). The median duration of response (mDoR)was 9.5 months (95% CI, 2.6 to Not reached), with a DoR rate at 12 months of 50% (95% CI, 5.8 to 84.5). The mPFS (6.0 v 1.0 months, P < .001) and mOS (17.6 v 4.0 months, P < .001) were prolonged in patients achieving partial response/stable disease than the progressive disease group. CA19-9 levels had reduced by at least 30% in 17 (70.8%) patients. CONCLUSION: In patients with metastatic PC after progression on previous therapy, CT041 demonstrated a tolerable safety profile and encouraging anticancer efficacy signals. Response benefit observed here needs to be ascertained in the future.
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