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1帕博利珠单抗治疗伴脑转移NSCLC患者的一项非随机、开放Ⅱ期试验的长期随访结果和生物标志物分析显示文摘背景与目的我们开展了一项帕博利珠单抗用于伴未治疗脑转移的非小细胞肺癌(non-small cell lung cancer,NSCLC)或黑色素瘤患者的疗效和安全性的II期试验,旨在评估程序性死亡受体1(programmed cell death 1,PD-1)抑制剂在中枢神经系统(central nervous system,CNS)中的疗效。中期结果已发表,现报道对NSCLC队列的更新分析结果。方法这是一项开放性、单中心、II期试验。纳入标准:年龄≥18岁,诊断为晚期NSCLC并伴有≥1个5 mm-20 mm脑转移病灶,既往从未治疗或之前放疗后进展,无神经系统症状,不需要激素治疗且美国东部肿瘤协作组(Eastern Cooperative Oncology Group,ECOG)<2分。患者每2周接受一次帕博利珠单抗(10 mg/kg)治疗。队列1为程序性死亡配体1(programmed cell death ligand 1,PD-L1)≥1%的患者,队列2为PD-L1<1%或未评估的患者。主要终点是脑转移患者缓解比例。所有经治患者均纳入疗效与安全性终点的分析。该研究已结束入组,并于Clinicaltrials.gov登记注册,注册号为NCT02085070。结果2014年3月31日-2018年5月21日,共42例患者接受治疗。中位随访时间为8.3个月(IQR:4.5个月-26.2个月)。队列1的37例患者中11例有脑转移缓解[29.7%(95%CI:15.9%-47.0%)]。队列2未观察到缓解。治疗相关的3级-4级不良事件(adverse events,AEs)包括2例肺炎、1例全身症状、1例结肠炎、1例肾上腺皮质功能不全、1例高血糖症和1例低钾血症。6例(14%)患者发生了治疗相关的严重不良事件,包括肺炎、急性肾损伤、低钾血症和肾上腺皮质功能不全。没有观察到治疗相关死亡病例。结论帕博利珠单抗治疗PD-L1≥1%的NSCLC伴脑转移患者有效,且对所有纳入的未经治疗的脑转移患者安全。需要进一步探索免疫治疗用于NSCLC合并CNS转移。Sarah B GOLDBERG Kurt A SCHALPER Scott N GETTINGER Amit MAHAJAN Roy S HERBST Anne C CHANG Rogerio LILENBAUM Frederick H WILSON Sacit Bulent OMAY James B YU Lucia JILAVEANU Thuy TRAN Kira PAVLIK Elin ROWEN Heather GERRSH Annette KOMLO Richa GUPTA Hailey WYATT Matthew RIBEIRO Yuval KLUGER Geyu ZHOU Wei WEI Veronica L CHANG Harriet M KLUGER 董晓荣(翻译/校对) 2021中国肺癌杂志2021,24,9:34
2皮质下小血管病诊断的共识声明显示文摘血管性认知损害是用于描述一组涉及大血管和小血管的散发性和遗传性异质性疾病的诊断术语。皮质下小血管病可导致腔隙性梗死和进行性白质损害。被称为宾斯旺格病(Binswanger's disease, BD)的进行性白质损害患者构成了从单纯血管性疾病到合并神经变性病变的疾病谱。BD患者是一个相对同质性的亚组,存在缺氧缺血、腔隙性梗死和炎症,它们协同作用破坏血脑屏障和髓鞘。通过临床、脑脊液、神经心理学和影像学检查获得的多模式疾病标记物能促进该亚组患者的鉴别。本共识声明确定了一系列基于基础病理学改变的潜在生物学标记物,这将有助于诊断以及将来协作性治疗试验的患者选择。Gary A Rosenberg Anders Wallin Joanna M Wardlaw Hugh S Markus Joan Montaner Leslie Wolfson Costantino Iadecola Berislav V Zlokovic Anne Joutel Martin Dichgans Marco Duering Reinhold Schmidt Amos D Korczyn Lea T Grinberg Helena C Chui Vladimir Hachinski 王训师 张劼 陈涵丰 俞娅美 徐子奇 罗本燕 2016国际脑血管病杂志2016,24,6:18
3Rilotumumab in combination with epirubicin, cisplatin, and capecitabine as first-line treatment for gastric or oesophagogastric junction adenocarcinoma: an open-label, dose de-escalation phase 1b study and a double-blind, randomised phase 2 study显示文摘Timothy Iveson Ross C Donehower Irina Davidenko Sergey Tjulandin Andrzej Deptala Mark Harrison Somanath Nirni Kuntegowdanahalli Lakshmaiah Anne Thomas Yizhou Jiang Min Zhu Rui Tang Abraham Anderson Sarita Dubey Kelly S Oliner Elwyn Loh 2014Lancet Oncology2014,,9:3
4Akt Promotes Cell Survival by Phosphorylating and Inhibiting a Forkhead Transcription Factor显示文摘Anne Brunet Azad Bonni Michael J Zigmond Michael Z Lin Peter Juo Linda S Hu Michael J Anderson Karen C Arden John Blenis Michael E Greenberg 1999Cell1999,,6:2
5Magnetic manipulation of copper-tin nanowires capped with nickel ends显示文摘ANNE K B JEREMY S T ARTHUR B E WENDY C C 2004Nano Letters2004,4,3:1
6Surgery analysis of fertility after ec- topic pregnancy显示文摘Anne E Damien S Michel C 2001Fertil Stetil2001,75,:1
7Exploring fungal biodiversity for the production of water-soluble pigments as potential natural food colorants显示文摘Jens C Frisvad Anne S Meyer Ulf Thrane 2005Current Opinion in Biotechnology2005,,16:1
8On-site sorting of con- struction and demolition waste in Hong Kong显示文摘Poon C S Ann T W Ng L H 2001Re- sources Conservation and Recycling2001,32,2:1
9Membrane filtration characteristics in membrane coupled activated sludge system: rile effect of flock structure of activated sludge on membrane fouling显示文摘Chang I S Lee C H Ann K H 1999Water Science Technology1999,34,9:1
10Biochemical and transcriptomic analyses of two bovine skeletal muscles in Charolais bulls divergently selected for muscle growth显示文摘Karine S Isabelle C M Anne L 2005Meat Science2005,70,2:1
11Near- and supercritical solvolysis of carbon fibre reinforced poly mers for recycling carbon fibers as a valuable resource: State of the art显示文摘CHISTELLE M ANNE L S FRANOIC C 2012The Journal of Supereritical Fluids2012,66,:1
12Progress with gene-product mapping of the Mollicutes:Mycoplasma genitalium显示文摘Wasinger V C Cordwell S J Anne C D 1995Electrophoresis1995,16,17:1
13Anion-selective electrodes based on ionic liquid membranes:effect of ionic liquid anion on observed response显示文摘PAJSNI G ANN M C WILLIAM M S 2011Analylical and Bioanalytical Chemistry2011,400,9:1
14Electrochemical property: Structure relationships in monoclinic Li3-yV2(P04)3 显示文摘YIN S C GRONDEY H STROBEL P ANNE M NAZAR L F 2003Journal of the American Chemical Society2003,125,10:1
15The Dioscorea genus: a review of bioactive steroid saponins显示文摘Marc S Anne C M Marie A L 2007J Nat Med2007,,61:1
16Nutrient removal by floating aquatic macrophytes cultured in anaerobically digested flushed dairy manure wastewater显示文摘Reeta D S Ann C W 2004Ecological Engineering2004,22,:1
17Survival analysis of fertility after ectopic pregncy显示文摘Anne E Damien S Michel C 2001Fertil Stetil2001,75,3:1
18Nutrient removal by floating aquatic macrophytes cultured in anaerobically digested flushed dairy manure wastewater显示文摘Reeta D S Ann C W 2004Ecological Engineering2004,22,:1
19A novel short peptide is a specific inhibitor of the Human Immunodeficiency Virus Type 1 Integrase显示文摘Vaea R S Anne C Vincent P 2002J Mol Biol2002,318,:1
20Private Label Positioning: Quality Versus Feature Differentiation from the National Brand显示文摘Choi S C Anne C T 2006Journal of Retailing2006,82,2:1
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