PDF(Pubmed)
Abstract：
UNASSIGNED: No standardized treatment strategy exists for managing oligoprogression during maintenance therapy in driver-negative advanced non-small cell lung cancer (NSCLC). Similarly, a uniform response to oligoprogression during maintenance therapy using immune checkpoint inhibitors (ICIs) has not been established. Consequently, our investigation focused on assessing the efficacy and safety of employing stereotactic total body radiotherapy in conjunction with ICIs to address oligoprogression in advanced NSCLC.
UNASSIGNED: We conducted a retrospective analysis of patients diagnosed with driver-negative advanced NSCLC who received stereotactic body radiotherapy (SBRT) in combination with ICIs to manage oligoprogressive lesions within the period from October 2018 to October 2023 at our institution. Oligoprogression, defined as progression occurring in three or fewer disease sites, was the focus of our investigation. Our assessment encompassed various parameters including the local control rate (LCR), progression-free survival post-oligoprogression (PFS-P), overall survival post-oligoprogression (OS-P), progression-free survival (PFS), overall survival (OS), and the safety profile associated with SBRT followed by sequential ICIs after oligoprogression.
UNASSIGNED: A total of 15 patients were enrolled in this study, all at stage IV, with 12 (80%) receiving a diagnosis of adenocarcinoma. Before oligoprogression, 11 (73.3%) patients had undergone immunotherapy. Following the treatment of oligoprogressed lung cancer with SBRT sequential ICIs, the median PFS-P and OS-P were 8 months (95% CI: 2.7-13.3) and 12 months (95% CI: 7.3-16.7), respectively. Additionally, the median PFS and OS were 26 months (95% CI: 8.0-44.0) and 30 months (not reached), respectively. The median local control (LC) of 15 oligoprogressed lesions was 13 months (95% CI: 5.3-20.2), with a 1-year LCR of 77.9%. Notably, patients with a performance status (PS) score of less than 2 demonstrated a more favorable survival benefit.
UNASSIGNED: Stereotactic systemic radiation therapy, combined with sequential ICIs, enhances both LC and survival in advanced NSCLC characterized by oligoprogression and negative driver gene mutations. This approach also exhibits the potential to postpone the transition between systemic chemotherapy regimens. Manageable adverse reactions were observed, with the absence of grade 4 reactions.
UNASSIGNED: We conducted a retrospective analysis of patients diagnosed with driver-negative advanced NSCLC who received stereotactic body radiotherapy (SBRT) in combination with ICIs to manage oligoprogressive lesions within the period from October 2018 to October 2023 at our institution. Oligoprogression, defined as progression occurring in three or fewer disease sites, was the focus of our investigation. Our assessment encompassed various parameters including the local control rate (LCR), progression-free survival post-oligoprogression (PFS-P), overall survival post-oligoprogression (OS-P), progression-free survival (PFS), overall survival (OS), and the safety profile associated with SBRT followed by sequential ICIs after oligoprogression.
UNASSIGNED: A total of 15 patients were enrolled in this study, all at stage IV, with 12 (80%) receiving a diagnosis of adenocarcinoma. Before oligoprogression, 11 (73.3%) patients had undergone immunotherapy. Following the treatment of oligoprogressed lung cancer with SBRT sequential ICIs, the median PFS-P and OS-P were 8 months (95% CI: 2.7-13.3) and 12 months (95% CI: 7.3-16.7), respectively. Additionally, the median PFS and OS were 26 months (95% CI: 8.0-44.0) and 30 months (not reached), respectively. The median local control (LC) of 15 oligoprogressed lesions was 13 months (95% CI: 5.3-20.2), with a 1-year LCR of 77.9%. Notably, patients with a performance status (PS) score of less than 2 demonstrated a more favorable survival benefit.
UNASSIGNED: Stereotactic systemic radiation therapy, combined with sequential ICIs, enhances both LC and survival in advanced NSCLC characterized by oligoprogression and negative driver gene mutations. This approach also exhibits the potential to postpone the transition between systemic chemotherapy regimens. Manageable adverse reactions were observed, with the absence of grade 4 reactions.
摘要：
■在驱动阴性的晚期非小细胞肺癌（NSCLC）的维持治疗期间，没有标准化的治疗策略来管理寡进展。同样，在使用免疫检查点抑制剂(ICIs)的维持治疗期间,尚未确定对寡进展的一致反应.因此,我们的研究重点是评估立体定向全身放疗联合ICIs治疗晚期NSCLC少发的疗效和安全性.
我们对被诊断为驾驶员阴性的晚期NSCLC的患者进行了回顾性分析，这些患者在2018年10月至2023年10月期间接受了立体定向全身放疗（SBRT）与ICI联合治疗，以治疗少进展性病变。寡头进展,定义为在三个或更少的疾病部位发生的进展，是我们调查的重点.我们的评估包括各种参数，包括本地控制率(LCR)，少进展后无进展生存期（PFS-P），寡头进展后总生存期（OS-P），无进展生存期（PFS），总生存期（OS），以及与SBRT相关的安全性概况，然后是少许进展后的序贯ICI。
■本研究共纳入15名患者，都在第四阶段,12（80％）接受腺癌诊断。在寡头进展之前，11例（73.3%）患者接受了免疫治疗。在用SBRT序贯ICIs治疗少进展肺癌后，中位PFS-P和OS-P分别为8个月(95%CI:2.7-13.3)和12个月(95%CI:7.3-16.7),分别。此外,中位PFS和OS分别为26个月(95%CI:8.0-44.0)和30个月(未达到),分别。15个少进展性病变的中位局部控制（LC）为13个月（95％CI：5.3-20.2），1年LCR为77.9%。值得注意的是,表现状况(PS)评分小于2分的患者表现出更有利的生存获益.
■立体定向全身放射治疗，结合顺序ICI，在以少进展和负驱动基因突变为特征的晚期NSCLC中，LC和生存率均得到提高。这种方法还显示出推迟全身化疗方案之间过渡的潜力。观察到可管理的不良反应，没有4级反应。
我们对被诊断为驾驶员阴性的晚期NSCLC的患者进行了回顾性分析，这些患者在2018年10月至2023年10月期间接受了立体定向全身放疗（SBRT）与ICI联合治疗，以治疗少进展性病变。寡头进展,定义为在三个或更少的疾病部位发生的进展，是我们调查的重点.我们的评估包括各种参数，包括本地控制率(LCR)，少进展后无进展生存期（PFS-P），寡头进展后总生存期（OS-P），无进展生存期（PFS），总生存期（OS），以及与SBRT相关的安全性概况，然后是少许进展后的序贯ICI。
■本研究共纳入15名患者，都在第四阶段,12（80％）接受腺癌诊断。在寡头进展之前，11例（73.3%）患者接受了免疫治疗。在用SBRT序贯ICIs治疗少进展肺癌后，中位PFS-P和OS-P分别为8个月(95%CI:2.7-13.3)和12个月(95%CI:7.3-16.7),分别。此外,中位PFS和OS分别为26个月(95%CI:8.0-44.0)和30个月(未达到),分别。15个少进展性病变的中位局部控制（LC）为13个月（95％CI：5.3-20.2），1年LCR为77.9%。值得注意的是,表现状况(PS)评分小于2分的患者表现出更有利的生存获益.
■立体定向全身放射治疗，结合顺序ICI，在以少进展和负驱动基因突变为特征的晚期NSCLC中，LC和生存率均得到提高。这种方法还显示出推迟全身化疗方案之间过渡的潜力。观察到可管理的不良反应，没有4级反应。
