2016年post-asco會后Meteor研究結果尼對照依維莫斯治療mRCC

杭州市腫瘤醫(yī)杭州市腫瘤醫(yī)腫瘤內主要內上皮癌：IMvigorstudy（#4500,Atezolizumab治療mUC腎癌：#4506,Meteor研究更新結果（卡博替尼對照依維莫斯治療Nivolumab治療mRCC長期隨訪結癌PRINCE研究多西他賽間歇療法對持續(xù)療法在CRPC的研主要內上皮癌：IMvigorstudy（#4500,Atezolizumab治療mUC腎癌：#4506,Meteor研究更新結果（卡博替尼對照依維莫斯治療Nivolumab治療mRCC長期隨訪結PRINCE研究多西他賽間歇療法對持續(xù)療法在CRPC的研PresentationAtezolizumabas1LTherapyinCisplatin-IneligibleLocallyAdvanced/MetastaticUrothelialCarcinoma:IMvigor210Cohort1ArjunVasantBalar,MattD.Galsky,YohannLoriot,NancyAnnDawson,AndreaNecchi,SandySrinivas,RichardWayneJoseph,UlkaN.Vaishampayan,SrikalaS.Sridhar,DavidI.Quinn,AlexandraDrakaki,IgnacioDuran,JonathanE.Rosenberg,ThomasPowles,JeanH.Hoffman-Censits,NaCui,SanjeevMariathasan,AnnChristineThastrom,OyewaleO.Abidoye,DeanF.Bajorin;PerlmutterCancerCenter,NYULangoneMedicalCenter,NewYork,NY;IcahnSchoolofMedicineatMountSinai,NewYork,NY;DepartmentofCancerMedicine,InstitutGustaveRoussy,Paris-SudUniversity,Villejuif,France;LombardiComprehensiveCancerCenter,Washington,DC;FondazioneIRCCSIstitutoNazionaledeiTumori,Milan,Italy;StanfordUniversityMedicalCenter,Stanford,CA;MayoClinic,Jacksonville,FL;KarmanosCancerInstitute,Detroit,MI;PrincessMargaretCancerCentre,Toronto,ON,Canada;UniversityofSouthernCaliforniaNorrisComprehensiveCancerCenter,LosAngeles,CA;WestwoodRheumatology,LosAngeles,CA;HospitalUniversitarioVirgendelRocío,Seville,Spain;MemorialSloanKetteringCancerCenter,NewYork,NY;BartsCancerInstitute,BartsHealth,andTheRoyalFreeLondonNHSFoundationTrust,London,UnitedKingdom;TheSidneyKimmelCancerCenteratThomasJeffersonUniversity,Philadelphia,PA;Genentech,Inc.,SouthSanFrancisco,CA;Genentech,Inc.,SanMateo,CA;Genentech,Inc.,SanFrancisco,CAPresentedByArjunBalarat2016ASCOAnnual 鉑類由于PS評分只接的生存獲 吉西他濱+卡鉑：ORR:36%，mOS:9.3m，21%患者因為毒性而中 PresentedByArjunBalarat2016ASCOAnnualPresentedByArjunBalarat2016ASCOAnnualPresentedByArjunBalarat2016ASCOAnnualPresentedByArjunBalarat2016ASCOAnnual PresentedByArjunBalarat2016ASCOAnnualPresentedByArjunBalarat2016ASCOAnnual有效者包齡、腎功能差、PresentedByArjunBalarat2016ASCOAnnualPresentedByArjunBalarat2016ASCOAnnualPresentedByArjunBalarat2016ASCOAnnualPresentedByArjunBalarat2016ASCOAnnualPresentedByArjunBalarat2016ASCOAnnualPresentedByArjunBalarat2016ASCOAnnual不能耐受順鉑治療的轉移性泌尿上皮癌Atezolizumab一線治療有持久的反應所 Atezolizumab可耐受，治療相關3/4級毒性和因為AE終止均比較PresentedByArjunBalarat2016ASCOAnnualPresentedByRobertDreicerat2016ASCOAnnual Atezolizumab是第一個被FDA加速批準治療mUC的PD-L1抑制劑（2016.5.18治療后疾病進展局部晚期或轉移性泌尿上皮PresentedByRobertDreicerat2016ASCOAnnualPresentedByRobertDreicerat2016ASCOAnnualPresentedByRobertDreicerat2016ASCOAnnualPresentedByRobertDreicerat2016ASCOAnnualPresentedByRobertDreicerat2016ASCOAnnual外的CR和5個2個PresentedByRobertDreicerat2016ASCOAnnualPresentedByRobertDreicerat2016ASCOAnnualPresentedByRobertDreicerat2016ASCOAnnualPresentedByRobertDreicerat2016ASCOAnnualPresentedByRobertDreicerat2016ASCOAnnualtezolizab第一個被FDD1PD1FDA批準基于對曾經治療過、預后差的轉移性泌尿上皮癌有較好的臨床反應PD-L1狀態(tài)所有亞組均有療效，但高表長期隨訪中可發(fā)現新的客觀反應及額外隨機Ⅲ期臨床研究對比化療正在進行（IMvigor211; PresentedByRobertDreicerat2016ASCOAnnual主要內上皮癌：IMvigorstudy（#4500,Atezolizumab治療mUC腎癌：#4506,Meteor研究更新結果（卡博替尼對照依維莫斯治療Nivolumab治療mRCC長期隨訪結癌PRINCE研究多西他賽間歇療法對持續(xù)療法在CRPC的研晚期腎癌治療概細胞因子治療mPFS3-5月，mOS最多17靶向治療mOS高達29TKI藥物和mTOR抑制劑為標準1線和2線治??mTOR抑制劑依維莫斯受卡博替尼、PD-1抑制劑晚期腎癌 評估MSKCC標PresentedByToniChoueiriat2016ASCOAnnualPresentedByToniChoueiriat2016ASCOAnnualCabozantinibCabozantinib是針對包括MET,VEGFR,AXL等信號位點酪氨酸酶抑制Ⅱ期隨機臨床研究Cabosun試驗顯示，未治療的RCC患者中，CabozantinibSunitinib具有顯著延長Ⅲ期隨機臨床研究METEOR試驗，曾經接受VEGRTKI治療后RCC，中位PFS：Cabozantinib7.4m對比Everolimus3.8m，HR?PresentedByToniChoueiriat2016ASCOAnnual每8每8PresentedByToniChoueiriat2016ASCOAnnualPresentedByToniChoueiriat2016ASCOAnnualPresentedByToniChoueiriat2016ASCOAnnualPresentedByToniChoueiriat2016ASCOAnnualPresentedByToniChoueiriat2016ASCOAnnualPresentedByToniChoueiriat2016ASCOAnnualPresentedByToniChoueiriat2016ASCOAnnualPresentedByToniChoueiriat2016ASCOAnnualPresentedByToniChoueiriat2016ASCOAnnualPresentedByToniChoueiriat2016ASCOAnnual此次更新的結果與既 卡博替尼和依維莫斯常見的 ?卡博替尼組：腹瀉75%，乏力 ?依維莫斯組：乏力48%，貧血39%，納差35%，咳嗽34%，氣促治療相關性AE均可以通過劑量調整減由于AE導致藥物中斷卡博替尼12%，依維莫斯PresentedByToniChoueiriat2016ASCOAnnualCabozantinib可以提高PFS和PresentedByToniChoueiriat2016ASCOAnnual Long-termoverallsurvival(OS)withnivolumabinpreviouslytreatedpatientswithadvancedrenalcellcarcinoma(aRCC)fromphaseIandIIstudiesDavidF.McDermott,RobertJ.Motzer,MichaelB.Atkins,ElizabethR.Plimack,MarioSznol,SabyGeorge,CharlesG.Drake,BrianI.Rini,ToniK.IanM.Waxman,HansJ.Hammers;BethIsraelDeaconessMedicalCenter,Boston,MA;MemorialSloanKetteringCancerCenter,NewYork,NY;prehensiveCancerCenter,Washington,DC;FoxChaseCancerCenter,Philadelphia,PA;YaleSchoolofMedicineandSmilowCancerCenter,Yale-NewHavenHospital,NewHaven,CT;RoswellParkCancerInstitute,Buffalo,NY;TheSidney CancerCenteratJohnsHopkins,Baltimore,MD;ClevelandClinicTaussigCancerInstitute,Cleveland,OH;Dana-Farber/BrighamandWomen'sⅢ期臨床研究CheckMate025研究提示，對于曾經行抗血管治療的轉移性Nivolumab比較Everolimus有顯著延長 本次數據是分析Ⅰ、Ⅱ期Nivolumab研究中隨訪超過4年的患者的生存期和安全PresentedByDavidMcDermottat2016ASCOAnnual治療持續(xù)：若SD治療至96主要：安治療持續(xù)：若SD持續(xù)治終點次要：ORR,OS，毒PresentedByDavidMcDermottat2016ASCOAnnualPresentedByDavidMcDermottat2016ASCOAnnualPresentedByDavidMcDermottat2016ASCOAnnualPresentedByDavidMcDermottat2016ASCOAnnualPresentedByDavidMcDermottat2016ASCOAnnualPresentedByDavidMcDermottat2016ASCOAnnualPresentedByDavidMcDermottat2016ASCOAnnualPresentedByDavidMcDermottat2016ASCOAnnualPresentedByDavidMcDermottat2016ASCOAnnualPresentedByDavidMcDermottat2016ASCOAnnualPresentedByDavidMcDermottat2016ASCOAnnual這是PD-1/PD-L1抑制劑治療 的隨訪最長數Nivolumab二線或多線治療aRCC數據提?約有1/3患者有4年生存（Ⅰ期和Ⅱ期），5年生存（Ⅰ期 ?安全性與既 類似，大部分治療相關AE常常在6月PresentedByDavidMcDermottat2016ASCOAnnualNext確確保PD-1抑制劑在mRCC的應用以增加有效?明確長期生存預測因?優(yōu)化治療持續(xù)時?更新臨床研究試驗設計，探索序貫次序、輔助及聯合治療對臨床預的影PresentedByDavidMcDermottat2016ASCOAnnual主要內上皮癌：IMvigorstudy（#4500,Atezolizumab治療mUC腎癌：#4506,Meteor研究更新結果（卡博替尼對照依維莫斯治療Nivolumab治療mRCC長期隨訪結癌PRINCE研究多西他賽間歇療法對持續(xù)療法在CRPC的研PresentedByHannesCashat2016ASCOAnnual間歇療法理論基享受治療假期-減少多西紫杉-沒有數據證明非劣PresentedByHannesCashat2016ASCOAnnualPresentedByHannesCashat2016ASCOAnnualPresentedByHannesCashat2016ASCOAnnualPresentedByHannesCashat2016ASCOAnnualPresentedByHannesC