PD-1/PD-L1 Inhibitor Plus Chemotherapy Versus PD-1/PD-L1 Inhibitor in Microsatellite Instability Gastrointestinal Cancers: A Multicenter Retrospective Study

被引：1

作者：

Chen, Mifen ^{[1
]}

Wang, Zhenghang ^{[1
]}

Liu, Zimin ^{[2
]}

Deng, Ting ^{[3
]}

Wang, Xiaodong ^{[4
]}

Chang, Zhiwei ^{[5
]}

Zhang, Qi ^{[1
]}

Yang, Wenlei ^{[6
]}

Liu, Ning ^{[2
]}

Ji, Zhi ^{[3
]}

Zhang, Xiaotian ^{[1
]}

Wang, Xicheng ^{[1
]}

Peng, Zhi ^{[1
]}

Li, Yi ^{[5
]}

Cao, Yujuan ^{[4
]}

Jin, Xuan ^{[7
]}

Lu, Hongxia ^{[8
]}

Qu, Huajun ^{[9
]}

Tang, Yong ^{[10
]}

Xu, Chunlei ^{[10
]}

Fang, Weijia ^{[11
]}

Zhang, Hangyu ^{[11
]}

Yan, Dong ^{[12
]}

Wang, Li ^{[12
]}

Li, Jiayi ^{[13
,14
]}

Zhang, Jingdong ^{[15
]}

Wang, Qiwei ^{[15
]}

Xue, Liying ^{[16
]}

Yin, Fei ^{[17
]}

Han, Guangjie ^{[17
]}

Cheng, Zhiqiang ^{[18
]}

Liu, Qing ^{[18
]}

Jin, Yongdong ^{[19
]}

Zhang, Yinjie ^{[19
]}

Li, Lanxing ^{[19
]}

Cao, Baoshan ^{[20
]}

Yao, Yanhong ^{[20
]}

Chen, Zhiyu ^{[21
]}

Zou, Jianling ^{[21
]}

Ying, Jieer ^{[22
]}

Wei, Qing ^{[22
]}

Tian, Tiantian ^{[23
,24
]}

Zhao, Weifeng ^{[25
]}

Li, Longmei ^{[26
]}

Zhang, Tong ^{[27
]}

Song, Fanghua ^{[28
]}

Ba, Ya-er ^{[29
]}

Li, Na ^{[30
]}

Gao, Hui ^{[31
]}

Ji, Yinghua ^{[32
]}

机构：

[1] Peking Univ Canc Hosp & Inst, Dept Gastrointestinal Oncol, Key Lab Carcinogenesis & Translat Res, Minist Educ, Beijing, Peoples R China

[2] Qingdao Univ, Affiliated Hosp, Dept Oncol, Qingdao, Shandong, Peoples R China

[3] Tianjin Med Univ, Natl Clin Res Ctr Canc, Tianjins Clin Res Ctr Canc,Canc Inst & Hosp, Dept Gastrointestinal Oncol,Key Lab Canc Prevent, Tianjin, Peoples R China

[4] Peking Univ, Shougang Hosp, Dept Oncol, Beijing, Peoples R China

[5] Zhengzhou Univ, Affiliated Hosp 1, Dept Oncol, Zhengzhou, Henan, Peoples R China

[6] Peking Univ Canc Hosp & Inst, Key Lab Carcinogenesis & Translat Res, Minist Educ Beijing, Lab Genet, Beijing, Peoples R China

[7] Peking Univ First Hosp, Dept Med Oncol, Beijing, Peoples R China

[8] Chinese Acad Med Sci, Shanxi Med Univ, Shanxi Prov Canc Hosp, Shanxi Hosp,Canc Hosp,Dept Gastroenterol, Taiyuan, Shanxi, Peoples R China

[9] Qingdao Univ, Affiliated Yantai Yuhuangding Hosp, Dept Med Oncol, Yantai, Shandong, Peoples R China

[10] Xinjiang Med Univ, Affiliated Tumor Hosp, Dept Digest Internal Med, Urumqi, Xinjiang, Peoples R China

[11] Zhejiang Univ, Affiliated Hosp 1, Sch Med, Dept Med Oncol, Hangzhou, Zhejiang, Peoples R China

[12] Capital Med Univ, Beijing Luhe Hosp, Dept Oncol, Beijing, Peoples R China

[13] Xiamen Univ, Affiliated Hosp 1, Dept Med Oncol, Xiamen, Peoples R China

[14] Xiamen Univ, Sch Med, Xiamen, Peoples R China

[15] China Med Univ, Canc Hosp, Liaoning Canc Hosp & Inst, Med Oncol Dept Gastrointestinal Canc, Shenyang, Peoples R China

[16] Peoples Hosp Inner Mongolia Autonomous Reg, Dept Med Oncol, Hohhot, Inner Mongolia, Peoples R China

[17] Hebei Med Univ, Hosp 4, Dept Gastroenterol & Hepatol, Shijiazhuang, Hebei, Peoples R China

[18] China Japan Friendship Hosp, Dept Integrat Oncol, Beijing, Peoples R China

[19] Univ Elect Sci & Technol China, Sichuan Canc Hosp & Inst, Sch Med, Sichuan Canc Ctr,Dept Med Oncol, Chengdu, Sichuan, Peoples R China

[20] Peking Univ Third Hosp, Dept Med Oncol & Radiat Sickness, Beijing, Peoples R China

[21] Fudan Univ, Shanghai Canc Ctr, Dept Gastrointestinal Med Oncol, Shanghai, Peoples R China

[22] Chinese Acad Sci, Univ Chinese Acad Sci, Zhejiang Canc Hosp, Canc Hosp,Inst Basic Med & Canc IBMC,Dept Abdomin, Hangzhou, Zhejiang, Peoples R China

[23] Shandong First Med Univ, Affiliated Hosp 1, Dept Oncol, Jinan, Shandong, Peoples R China

[24] Shandong Prov Qianfoshan Hosp, Jinan, Shandong, Peoples R China

[25] Henan Univ, Zhengzhou Univ, Henan Prov Peoples Hosp, Peoples Hosp,Dept Oncol, Zhengzhou, Henan, Peoples R China

[26] Guangzhou Univ Chinese Med, Guangdong Prov Hosp Chinese Med, Clin Coll 2, Dept Oncol, Guangzhou, Guangdong, Peoples R China

[27] China Acad Chinese Med Sci, Xiyuan Hosp, Dept Oncol, Beijing, Peoples R China

[28] Dalian Univ, Affiliated Xinhua Hosp, Dept Oncol, Dalian, Liaoning, Peoples R China

[29] Baotou Canc Hosp, Dept Internal Med, Baotou, Inner Mongolia, Peoples R China

[30] Suining Cent Hosp, Canc Ctr, Suining, Sichuan, Peoples R China

[31] Zhengzhou Univ, Zhengzhou Cent Hosp, Dept Oncol Rehabil, Zhengzhou, Henan, Peoples R China

[32] Xinxiang Med Univ, Affiliated Hosp 1, Dept Oncol, Xinxiang, Henan, Peoples R China

[33] Manzhouli Peoples Hosp, Dept Med Oncol, Manzhouli, Inner Mongolia, Peoples R China

[34] 3D Med Inc, Med Affairs, Shanghai, Peoples R China

来源：

JCO PRECISION ONCOLOGY | 2023年 / 7卷

基金：

中国国家自然科学基金;

关键词：

REPAIR-DEFICIENT; SOLID TUMORS; OPEN-LABEL; NIVOLUMAB; PEMBROLIZUMAB; BURDEN; CHINA;

D O I：

10.1200/PO.22.00463

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

PURPOSETo investigate the efficacy of PD-1/PD-L1 inhibitors plus chemotherapy versus anti-PD-1/PD-L1 monotherapy in advanced microsatellite instability (MSI)/mismatch repair-deficient (dMMR) gastrointestinal cancers.METHODSWe retrospectively recruited patients with MSI/dMMR gastrointestinal cancer who received anti-PD-1/PD-L1 with or without chemotherapy and compared objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS) of PD-1/PD-L1 inhibitor plus chemotherapy (chemo-anti-PD-1/PD-L1 group) and PD-1/PD-L1 inhibitor alone (anti-PD-1/PD-L1 group). Propensity score-based overlap weighting analysis was conducted to adjust the baseline covariable imbalance. Sensitivity analysis was performed to confirm the stability of the results by propensity score matching and multivariable Cox and logistic regression models.RESULTSA total of 256 patients were eligible, with 68 and 188 receiving chemo-anti-PD-1/PD-L1 and anti-PD-1/PD-L1, respectively. The chemo-anti-PD-1/PD-L1 group showed significant improvements versus the anti-PD-1/PD-L1 group in ORR (61.8% v 38.8%; P = .001), DCR (92.6% v 74.5%; P = .002), PFS (median PFS [mPFS], not reached [NR] v 27.9 months; P = .004), and OS (median OS [mOS], NR v NR; P = .014). After overlap weighting, the improvements tended to be more significant with chemo-anti-PD-1/PD-L1 versus anti-PD-1/PD-L1 in ORR (62.5% v. 38.3%; P < .001), DCR (93.8% v 74.2%; P < .001), PFS (mPFS, NR v 26.0 months; P = .004), and OS (mOS, NR v NR; P = .010). These results were solidified through sensitivity analysis.CONCLUSIONChemo-anti-PD-1/PD-L1 is superior to anti-PD-1/PD-L1 in MSI/dMMR gastrointestinal cancers with improved efficacy.

引用

页数：20

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