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Application of Immune-checkpoint Inhibitors in Recurrent/Metastatic Nasopharyngeal Carcinoma
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摘要:
鼻咽癌多与EB病毒感染相关，早期患者及时治疗后预后良好，但复发/转移性鼻咽癌治疗方式有限，预后不佳。近年来，免疫治疗在复发/转移性鼻咽癌中的研究十分广泛，其中免疫检查点抑制剂药物具有较好的疗效和良好的耐受性，引起临床广泛关注。程序性死亡受体-配体1(programmed death-ligand 1, PD-L1)表达状态、肿瘤突变负荷、循环EB病毒-DNA水平可能成为免疫检查点抑制剂疗效预测的生物标志物。本文将对免疫检查点抑制剂及其在复发/转移性鼻咽癌中的应用进行综述。
Abstract:Nasopharyngeal carcinoma is mainly associated with Epstein-Barr virus(EBV) infection. The treatment of early nasopharyngeal carcinoma has a good prognosis, but the treatment options for recurrent/metastatic nasopharyngeal carcinoma are limited and the prognosis is poor. In recent years, there have been extensive studies on immunotherapy in advanced nasopharyngeal carcinoma, among which immune-checkpoint inhibitors are effective and causing clinical concern. Programmed death-ligand 1 expression status, tumor mutation burden and circulating EBV-DNA level may be biomarkers for predicting the efficacy of immune-checkpoint inhibitors. The applications of immune-checkpoint inhibitors in recurrent/metastatic nasopharyngeal carcinoma will be reviewed in this article.
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Key words:
- nasopharyngeal carcinoma /
- immune-checkpoint inhibitor /
- biomarker
作者贡献: 高洋查阅文献、撰写论文;孙昭指导、修改论 文;白春梅确立研究方向、提出修改意见。利益冲突 无 -
表 1 正在进行中的鼻咽癌免疫检查点抑制剂相关临床研究汇总
试验编号 肿瘤类别 肿瘤期别 干预措施 治疗地位 纳入人数(n) 试验阶段 目前状态 NCT03558191 鼻咽癌 Ⅳ期 SHR-1210 三线及以上 155 Ⅱ期 招募中 NCT03427827 鼻咽癌 Ⅲ~ⅣA期 SHR-1210 辅助治疗 400 Ⅲ期 招募中 NCT03707509 鼻咽癌 Ⅳ期 吉西他滨+顺铂±SHR-1210 一线 250 Ⅲ期 招募中 NCT03121716 鼻咽癌 Ⅳ期 SHR-1210+吉西他滨+顺铂 一线 20 Ⅰ期 开启，尚未招募 NCT02875613 鼻咽癌 Ⅳ期 Avelumab 二线及以上 39 Ⅱ期 开启，尚未招募 NCT02611960 鼻咽癌 Ⅳ期 Avelumab 二线及以上 39 Ⅱ期 开启，尚未招募 NCT03769467 鼻咽癌 Ⅳ期 帕博利珠单克隆抗体+CTL (Tabelecleucel) 一线 60 Ⅰ/Ⅱ期 招募中 NCT03082534 头颈部鳞癌、鼻咽癌等 Ⅳ期 帕博利珠单克隆抗体+西妥昔单抗 分一线/二线及以上亚组 83 Ⅱ期 招募中 NCT02538510 头颈部肿瘤、唾液腺癌 Ⅳ期 帕博利珠单克隆抗体+伏立诺他 不限 49 Ⅰ/Ⅱ期 开启，尚未招募 NCT03267498 鼻咽癌 Ⅱ~ⅣB期 纳武利尤单抗+顺铂+放疗 辅助治疗 40 Ⅱ期 招募中 NCT03097939 鼻咽癌 Ⅳ期 纳武利尤单抗+伊匹单抗 一线或二线 40 Ⅱ期 招募中 NCT02834013 鼻咽癌等多种罕见肿瘤 Ⅳ期 纳武利尤单克隆抗体+伊匹单抗 二线及以上 707 Ⅱ期 招募中 NCT03619824 鼻咽癌 Ⅲ~ⅣA期 Sintilimab(IBI308)+吉西他滨+顺铂+放疗 诱导治疗 40 Ⅱ期 尚未招募 NCT03700476 鼻咽癌 Ⅲ~ⅣA期 吉西他滨+顺铂+放疗±Sintilimab 诱导治疗 420 Ⅲ期 尚未招募 NCT02605967 鼻咽癌 Ⅳ期 PDR001或化疗 二线及三线 122 Ⅱ期 招募中 NCT03866967 鼻咽癌 Ⅳ期 AK105 三线及以上 153 Ⅱ期 招募中 NCT03474640 晚期恶性肿瘤 Ⅳ期 Toripalimab 二线及以上 258 Ⅰ期 招募中 NCT03752398 晚期实体瘤 Ⅳ期 XmAb®23104 二线及以上 144 Ⅰ期 尚未招募 
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