晚期子宫内膜癌免疫治疗的探索  

Immunotherapy for advanced endometrial cancer:an exploratory study

作　　者：吴迪[1] 闫志风[2] 李明霞 孟元光[1,2] Wu Di;Yan Zhifeng;Li Mingxia;Meng Yuanguang(Medical School of Nankai University,Tianjin 300071,China;Department of Obstetrics and Gynecology,Chinese People's Liberation Army General Hospital,Beijing 100853,China)

机构地区：[1]南开大学医学院,天津300071 [2]解放军总医院妇产医学部,北京100853

出　　处：《中华临床医师杂志（电子版）》2024年第3期231-237,共7页Chinese Journal of Clinicians(Electronic Edition)

基　　金：国家自然科学基金青年基金(82103063)。

摘　　要：目的本研究拟总结晚期内膜癌免疫治疗的不同介入时机和联合方案的实践经验,以期探索免疫治疗的规范治疗,指导临床实践和生存获益。方法回顾性收集2020年6月~2022年12月期间在解放军总医院第一医学中心妇科收治并在手术前接受PD-1抑制剂治疗的初治和复发Ⅲ-Ⅳ期(参考FIGO分期标准)子宫内膜癌患者病历,评价免疫治疗疗效和安全性。结果(1)在疗效评价方面,10例不同时机经免疫治疗的患者中,2例(20%)CR,5例(50%)PR,1例(10%)SD和2例(20%)PD。总体客观缓解率(objective response rate,ORR)达70%。(2)在安全性评价方面,2例发生免疫治疗相关不良反应,1例G2级对症治疗缓解,1例G3级永久停用免疫检查点抑制剂。总体安全性可控,无免疫治疗相关死亡。结论晚期子宫内膜癌应用免疫一线或复发后线治疗均可促进肿瘤缓解并且延长PFS,同时免疫治疗安全可控。Objective To summarise the practical experience with different timing of intervention and combination regimens for immunotherapy in advanced endometrial cancer,with a view to exploring the standard of care in immunotherapy and guiding clinical practice to obtain survival benefit.Methods The medical records of patients with primary and recurrent stageⅢ-Ⅳ(FIGO staging criteria)endometrial cancer admitted to the Department of Gynaecology of the First Medical Center of the General Hospital of the People's Liberation Army(PLA)and treated with a PD-1 inhibitor prior to surgery from June 2020 to December 2022 were retrospectively collected to evaluate the efficacy and safety of immunotherapy.Results In terms of efficacy evaluation,among the 10 patients who were treated with immunotherapy at different times,2(20%)achieved complete response,5(50%)achieved partial response,1(10%)had stable disease,and 2(20%)had progressive disease,with an overall objective response rate of 70%.Regarding safety,immunotherapy-related adverse reactions occurred in 2 cases,of which 1 was grade 2 and relieved by symptomatic treatment,and 1 was grade 3 and resulted in permanent discontinuation of the immunocheckpoint inhibitor.The overall safety was manageable and there were no immunotherapy-related deaths.Conclusion Immunotherapy for advanced endometrial cancer,either primary or recurrent,promotes tumour remission and prolongs progression-free survival,with an acceptable safey profile.

关 键 词：晚期子宫内膜癌 免疫治疗 新辅助治疗 维持治疗 

分 类 号：R737.33[医药卫生—肿瘤]