■免疫疗法在许多癌症中显示出巨大的疗效,但其在胰腺导管腺癌(PDAC)中的作用尚不清楚。这项研究的目的是使用国家癌症数据库(NCDB)研究免疫疗法对未接受胰腺原发肿瘤部位确定性手术的PDAC患者的总生存期的影响。
■未接受手术的胰腺腺癌患者来自NCDB。Cox比例风险模型用于评估在诊断时调整年龄后免疫疗法对生存的影响。种族,性别,居住的地方,收入,教育,处理设施类型,保险状况,诊断年份,以及化疗和放疗等治疗类型。
■在接受分析的263,886名患者中,911(0.35%)接受了免疫治疗。在接受化疗的患者中(101,546),和放化疗(30,226)治疗,555/101,546(0.55%)接受化疗加免疫治疗,和299/3,022(9.9%)接受放化疗加免疫疗法。在针对上述因素进行调整的多变量分析中,与无免疫治疗相比,免疫治疗与OS显著改善相关(HR:0.866(0.800-0.937);P<0.001).与不进行免疫治疗的化疗相比,化疗加免疫治疗与OS改善显着相关(HR:0.848(0.766-0.938);P<0.001)。Further,与单纯放化疗相比,放化疗加免疫治疗与OS显著改善相关(HR:0.813(0.707-0.936);P<0.001)。
■在这项研究中,在未进行明确手术的PDAC患者中,在化疗和放化疗治疗的基础上增加免疫治疗与OS显著改善相关.这项研究保证了未来PDAC免疫治疗的临床试验。
UNASSIGNED: Immunotherapy has shown great efficacy in many cancers, but its role in pancreatic ductal adenocarcinoma (PDAC) remains unclear. The objective of this study was to investigate the impact of immunotherapy on the overall survival of PDAC patients who did not receive definitive surgery of the pancreatic primary tumor site using the National Cancer Database (NCDB).
UNASSIGNED: Patients with pancreatic adenocarcinoma who did not receive surgery were identified from NCDB. Cox proportional hazard models were employed to assess the impact of immunotherapy on survival after adjusting for age at diagnosis, race, sex, place of living, income, education, treatment facility type, insurance status, year of diagnosis, and treatment types such as chemotherapy and radiation therapy.
UNASSIGNED: Of 263,886 patients who were analyzed, 911 (0.35%) received immunotherapy. Among patients who received chemotherapy (101,546), and chemoradiation (30,226) therapy, 555/101,546 (0.55%) received chemotherapy plus immunotherapy, and 299/3,022 (9.9%) received chemoradiation plus immunotherapy. In a multivariable analysis adjusted for the factors mentioned above, immunotherapy was associated with significantly improved OS (HR: 0.866 (0.800-0.937); P < 0.001) compared to no immunotherapy. Chemotherapy plus immunotherapy was significantly associated with improved OS (HR: 0.848 (0.766-0.938); P < 0.001) compared to chemotherapy without immunotherapy. Further, chemoradiation plus immunotherapy was associated with significantly improved OS (HR: 0.813 (0.707-0.936); P < 0.001) compared to chemoradiation alone.
UNASSIGNED: In this study, the addition of immunotherapy to chemotherapy and chemoradiation therapy was associated with significantly improved OS in PDAC patients without definitive surgery. The study warrants future clinical trials of immunotherapy in PDAC.