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| 1 | 帕博利珠单抗单用或与放疗联用治疗转移性非小细胞肺癌:两个随机试验的汇总分析显示文摘背景放疗可以提高整个机体对免疫治疗的应答。在Ⅱ期PEMBRO-RT研究和Ⅰ/Ⅱ期MDACC研究中,患有转移性非小细胞肺癌(NSCLC)的患者被随机分配入组,接受免疫治疗(帕博利珠单抗)+放疗联合疗法,或免疫治疗单一疗法。当上述2个研究单独分析时,联合疗法组显示出潜在获益。由于每个研究的样本量较小,缓解率和结局并未显示出统计学意义,然而却有显著的临床获益。因此,本研究进行汇总分析,来判断放疗是否会改善转移性NSCLC患者的免疫治疗应答。方法PEMBRO-RT和MDACC研究纳入标准:患者年龄≥18岁,患有转移性NSCLC,且有≥1处未经放疗照射的病灶,以便进行射野外应答监测。PEMBRO-RT研究纳入曾接受过化疗患者,MDACC研究纳入曾接受过治疗或新诊断患者。2个研究中的患者均未接受过免疫治疗。在PEMBRO-RT研究中患者被等比例随机分配入组,并根据吸烟状态进行分层(分为<10年组和≥10年组)。MDACC研究的患者根据放疗计划可行性被等比例随机分配入2个受试组。由于联合治疗组的干预本质,每个研究中的放疗均不适用盲法。在2个研究中,不论是否进行放疗,均静脉滴入帕博利珠单抗(每3周200 mg)。在PEMBRO-RT研究中,在放疗(24 Gy 3次分割照射)结束后1周给予第1剂帕博利珠单抗。在MDACC研究中,在第1次放疗(50 Gy 4次分割照射或45 Gy 15次分割照射)同时给予帕博利珠单抗。仅检测未经照射病灶的应答。本研究的终点为最佳射野外(远隔)应答率(ARR)、最佳射野外疾病控制率(ACR)、12周时ARR、12周时ACR、无进展生存期(PFS)和总生存期(OS)。2个研究的意向治疗(ITT)人群均纳入分析。PEMBRO-RT研究(NCT02492568)和MDACC研究(NCT02444741)均在ClinicalTrials.gov上注册。发现纳入148例患者,76例接受帕博利珠单抗治疗,72例接受帕博利珠单抗+放疗治疗。所有患者随访时间中位数为33个月[四分位距(IQR):32.4~33.6]。148例患者中124例(84%)组织学特征为非鳞癌,111例(75%)患者曾经接受过化疗。组间没有基线特征差异,包括PD-L1表达状态和转移灶体积。最常见的照射部位为肺转移灶(39%,28/72)、胸腔内淋巴结(21%,15/72)和非原发灶(17%,12/72)。帕博利珠单抗组和联合治疗组的最佳ARR分别为19.7%(15/76)和41.7%(30/72),OR=2.96,95%CI:1.42~6.20,P=0.0039;最佳ACR分别为43.4%(33/76)和65.3%(47/72),OR=2.51,95%CI:1.28~4.91,P=0.0071;PFS中位数分别为4.4(IQR:2.9~5.9)和9.0个月(IQR:6.8~11.2),HR=0.67,95%CI:0.45~0.99,P=0.045;OS中位数分别为8.7(IQR:6.4~11.0)和19.2个月(IQR:14.6~23.8),OR=0.67,95%CI:0.54~0.84,P=0.0004。在汇总分析中没有发现新的安全问题。解读帕博利珠单抗免疫疗法+放疗显著提高转移性NSCLC患者的应答和改善治疗结局。这些结果需要在三期临床试验中进行验证。 | 陈大卫(翻译) 于金明(校对) Willemijn S M E Theelen Vivek Verma Brian P Hobbs Heike M U Peulen Joachim G J V Aerts Idris Bahce Anna Larissa N Niemeijer Joe Y Chang Patricia M de Groot Quynh-Nhu Nguyen Nathan I Comeaux George R Simon Ferdinandos Skoulidis Steven H Lin Kewen He Roshal Patel John Heymach Paul Baas James W Welsh | 2021 | 中华肿瘤防治杂志2021，28，24： | 49 |
| 2 | Imaging of liver cancer显示文摘Improvements in imaging technology allow exploitation of the dual blood supply of the liver to aid in the identif ication and characterisation of both malignant and benign liver lesions. Imaging techniques available include contrast enhanced ultrasound, computed tomography and magnetic resonance imaging. This review discusses the application of several imaging techniques in the diagnosis and staging of both hepatocellular carcinoma and cholangiocarcinoma and outlines certain characteristics of benign liver lesions. The advantages of each imaging technique are highlighted, while underscoring the potential pitfalls and limitations of each imaging modality. | Ben Ariff Claire R Lloyd Sameer Khan Mohamed Shariff Andrew V Thillainayagam Devinder S Bansi Shahid A Khan Simon D Taylor-Robinson Adrian KP Lim | 2009 | World Journal of Gastroenterology2009，15，11： | 4 |
| 3 | Ventricular repolarization components on the electrocardiogram显示文摘 | Gan-Xin Yan Ramarao S Lankipalli James F Burke Simone Musco Peter R Kowey | 2003 | Journal of the American College of Cardiology2003，，： | 2 |
| 4 | An ant colony system approach for unit commitment problem显示文摘 | Simon S P Padhy N P Anand R S | 2006 | Electrical Power and Energy System2006，，28： | 1 |
| 5 | Task conflict and relationship conflict in top management teams: the pivotal role of intragroup trust 显示文摘 | SIMONS T L R S PETERSON | 2000 | Journal of Applied Psychology2000，85，1： | 1 |
| 6 | Heparin and low-dose aspirin restore placental human chorlonic gonadotrophin secretion abolished by antiphospholipid antibody-containing sere 显示文摘 | Di simone N Ferrazzai S Castellani R | 1997 | Hum Reprod1997，12，： | 1 |
| 7 | Mayo clinic Scottsdale experience with laparoscopic nephron sparing surgery for renal tumors 显示文摘 | Simon S D Ferrigni R G Novicki D E | 2003 | J Urol2003，169，6： | 1 |
| 8 | A review of ac- celerated carbonation technology in the treatment of cement- based materials and sequestration 'of CO2 显示文摘 | Fernandez Bertos M Simons S J R Hills C D | 2004 | Journal of Hazard- ous Materia/s2004，112，3： | 1 |
| 9 | The phase II urokinase-streptokinase pulmonary embolism trial: a national cooperative study显示文摘 | Sasahra A A Bell W R Simon T L Stengle J M Sherry S | 1975 | Thromb Diath Haemorrh1975，33，： | 1 |
| 10 | Ankle arthrodesis: long-term follow-up with gait analysis 显示文摘 | Mazur J M Schwartz E Simon S R | 1979 | J Bone Jiont Surg(Am)1979，61，7： | 1 |
| 11 | Task conflict and relationship conflict in top management teams: The pivotal role of intragrouptrust显示文摘 | SIMONS T L PETERSON R S | 2000 | Journal of applied psychology2000，85，1： | 1 |
| 12 | Clinical drug development:an analysis of phase Ⅱ trials, 1970-1985 显示文摘 | Marsoni S Hoth D Simon R | 1987 | Cancer Treat Rep1987，71，1： | 1 |
| 13 | Histone deacetylase inhibitors a new tool to treat cancer显示文摘 | Somech R Izraelia S Simon A J | 2004 | Cancer Treatment Reviews2004，30，5： | 1 |
| 14 | Comparison of the proteolytic sus- ceptibilities of homologous L - amino acid, D - amino acid, and N - substituted glycine peptide and peptoid oligomers 显示文摘 | Miller S M Simon R J Ng S | 1995 | Drug Develop- ment Research1995，35，1： | 1 |
| 15 | Quantum simulation of antiferromagnetic spin chains in an optical lattice 显示文摘 | Simon J Bakr W S Ma R | 2011 | Nature(London)2011，472，： | 1 |
| 16 | PTEN deletion is rare but often homogeneous in gastric cancer显示文摘 | Mina S Bohn BA Simon R | 2012 | Clinical Pathology2012，65，8： | 1 |
| 17 | The role of prefrontal cortex in verbal episodic memory: rTMS evidence显示文摘 | Marco S Stefano F C Simone R | 2003 | Journal of Cognitive Neuroscienee2003，15，6： | 1 |
| 18 | Task conflict and relationship conflict in top management teams: The pivotal role of intragroup trust显示文摘 | SIMONS T L PETERSON R S | 2000 | Journal of Ap- plied Psychology2000，85，1： | 1 |
| 19 | Phylogenetic relationships in the genus Rosa:new evidence from chloroplast DNA sequences and an appraisal of current knowledge显示文摘 | ANNE B JUKIAN R S SIMON J | 2007 | Sysematic Botany2007，32，2： | 1 |
| 20 | High -resolution Xist binding maps reveal two - step spreading during X - chromosome in- activation 显示文摘 | SIMON M D PINTER S F FANG R | 2013 | Nature2013，504，7480： | 1 |
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