ngµç×ÓÓÎÏ·

03
Ê×Ò³ / ½Ìѧ¿ÆÑÐ / ÕýÎÄ

ÕÅÁ¦½ÌÊÚÍŶÓΪ·Î°©»¼Õß´øÀ´ÃâÒßÖÎÁÆÐ·½°¸

¸å¼þȪԴ£º£ºÖ×Áö·ÀÖÎÖÐÐÄ ±à¼­£º£ºÂ¬ì½Î¬ ÉóºË£º£ºËïÒ«±ó ÔĶÁÁ¿£º£º

ngµç×ÓÓÎÏ·ÐÂÎÅÍøÑ¶£¨Í¨Ñ¶Ô±Ö£Ãôɺ£©2024Äê5ÔÂ31ÈÕ£¬£¬ngµç×ÓÓÎÏ·Ö×Áö·ÀÖÎÖÐÐÄÕÅÁ¦½ÌÊÚǣͷ¿ªÕ¹µÄIIIÆÚHARMONi-A£¨AK112-301£©Ñо¿ÆÚÖÐÆÊÎöЧ¹û£¬£¬±»2024ÄêÃÀ¹úÁÙ´²Ö×Áöѧ»á£¨ASCO£©ÊÕ¼Ϊ¿ÚÍ·±¨¸æ£¬£¬ÓÉÕÅÁ¦½ÌÊÚÔÚASCO»áÉÏ×÷¿ÚÍ·±¨¸æ¡£Ñо¿Ð§¹ûͬ²½ÔÚ¹ú¼Ê¶¥¼âȨÍþÆÚ¿¯¡¶ÃÀ¹úҽѧ»áÔÓÖ¾¡·£¨JAMA£©ÔÚÏß½ÒÏþ¡£±¾ÎĵÄͨѶ×÷ÕßÊÇngµç×ÓÓÎÏ·Ö×Áö·ÀÖÎÖÐÐÄÕÅÁ¦½ÌÊÚ£¬£¬ÅäºÏµÚÒ»×÷Õß°üÀ¨ngµç×ÓÓÎÏ·Ö×Áö·ÀÖÎÖÐÐÄ·½ÎÄ·å½ÌÊÚ¡¢¡¢¡¢ÕÔæÂæÂÖ÷ÈÎҽʦ¡¢¡¢¡¢»ÆÑÒÖ÷ÈÎҽʦµÈ¡£

HARMONi-AÑо¿ÊÇÊ׸ö½ÏÁ¿ÁËÒÀÎÖÎ÷µ¥¿¹ÁªºÏ»¯ÁÆÓëµ¥¶À»¯ÁÆÔÚEGFR-TKIÄÍÒ©µÄEGFRÍ»±äÍíÆÚ»ò×ªÒÆÐÔnsq-NSCLCÁÆÐ§µÄ˫ä¡¢¡¢¡¢Î¿½å¼Á±ÈÕÕ¡¢¡¢¡¢Ëæ»úµÄIIIÆÚÑо¿¡£¡°ÒÀÎÖÎ÷µ¥¿¹ÁªºÏ»¯ÁÆ¡±Í»ÆÆEGFR-TKIÖÎÁƺóÄÍÒ©µÄÁÙ´²Äæ¾³£¬£¬ÎªEGFR-TKIÄÍÒ©µÄ·ÇСϸ°û·Î°©»¼Õß´øÀ´È«Ðµıê×¼ÖÎÁÆ·½°¸¡£HARMONi-AÑо¿Ò²ÕÃÏÔÁË¡°ÖйúѧÕß+±¾ÍÁÐÂÒ©¡±×éºÏµÄÇ¿¾¢ÊµÁ¦£¬£¬Êǹú¼ÊѧÊõ½ç¶Ô¹ú²úÊ×´´Ë«¿¹ÐÂÒ©·½°¸µÄÈϿɡ£

EGFR-TKIÊÇEGFRÍ»±ä·ÇСϸ°û·Î°©µÄ±ê×¼Ò»ÏßÖÎÁÆ£¬£¬µ«»ñµÃÐÔÄÍÒ©²»¿É×èÖ¹¡£ÏÖÔÚÁÙ´²ÉÏEGFR-TKIÓÈÆäÊǵÚÈý´úTKIÖÎÁÆÏ£Íû»¼Õߣ¬£¬×î¼ÑµÄÖÎÁÆÑ¡ÔñÈÔÈ»ÓÐÏÞ¡£

2021Äê11Ô£¬£¬ÕÅÁ¦½ÌÊÚǣͷµÄIIIÆÚHARMONi-AÑо¿ÔÚÖйúÆô¶¯£¬£¬ÌìÏÂ55¸öÑо¿ÖÐÐĹ²ÄÉÈë322ÀýEGFR-TKIÖÎÁÆÊ§°ÜµÄ·ÇСϸ°û·Î°©£¬£¬Ëæ»ú£¨1:1£©½ÓÊÜÒÀÎÖÎ÷µ¥¿¹£¨n=161£©»òο½å¼Á£¨n=161£©ÁªºÏÅàÃÀÇúÈû+¿¨²¬Q3W 4¸öÖÜÆÚÖÎÁÆ£¬£¬Ëæºó½ÓÊÜÒÀÎÖÎ÷µ¥¿¹+ÅàÃÀÇúÈû»òο½å¼Á+ÅàÃÀÇúÈûµÄά³ÖÖÎÁÆ¡£Ö÷ÒªÖÕµãÊÇÆ¾Ö¤RECISTv1.1±ê×¼ÓÉ×ÔÁ¦·ÅÉäѧÆÀÉóίԱ»á£¨IRRC£©ÆÀ¹ÀµÄÒâÏòÖÎÁÆ£¨ITT£©ÈËȺµÄÎÞÏ£ÍûÉúÑÄÆÚ£¨PFS£©¡£

¾­Óɽü3ÄêµÄ¶àÖÐÐÄ˫ä¡¢¡¢¡¢Î¿½å¼Á±ÈÕÕ¡¢¡¢¡¢Ëæ»úµÄIIIÆÚÑо¿£¬£¬HARMONi-AÑо¿³ÊÏÖ³öÁîÒµ½ç¾ªÏ²µÄЧ¹û¡£

ÑÓÉìÎÞÏ£ÍûÉúÑÄÆÚ£¬£¬¼²²¡Ï£Íû»òéæÃü·çÏÕ½µµÍ54%

×èÖ¹2023Äê3ÔÂ10ÈÕ£¬£¬ÖÐÎ»Ëæ·Ãʱ¼äΪ7.89¸öÔ£¬£¬ÆÚÖÐÆÊÎöЧ¹ûÏÔʾ£¬£¬ÒÀÎÖÎ÷µ¥¿¹ÁªºÏ·½°¸Ïà±È»¯ÁÆ¿ÉÏÔÖøÑÓÉ컼ÕßÎÞÏ£ÍûÉúÑÄÆÚ£¨PFS£©£¨7.06¸öÔÂvs 4.8¸öÔ£¬£¬HR=0.46£¬£¬95% CI 0.34~0.62£¬£¬P<0.001£©£¬£¬½µµÍ¼²²¡Ï£Íû»òéæÃü·çÏÕ´ï54%¡£

ÒÀÎÖÎ÷µ¥¿¹ÁªºÏ»¯ÁÆÔÚ3¸öÔ£¨94.7%¶Ô69.7%£©¡¢¡¢¡¢6¸öÔ£¨55.4%¶Ô33.1%£©ºÍ9¸öÔ£¨37.9%¶Ô18.3%£©µÄÎÞÏ£ÍûÉúÑÄÆÚÂʾù¸ßÓÚµ¥¶À»¯ÁÆ¡£

ÑÇ×éÆÊÎöÏÔʾ£¬£¬ÏÕЩËùÓÐÔ¤ÉèÑÇ×é¶¼ÊӲ쵽Óë×ÜÈËȺһÖµÄÎÞÏ£ÍûÉúÑÄÆÚ»ñÒæ£¬£¬²¢¾ßÓÐÏÔÖøÍ³¼ÆÑ§ÒâÒå¡£ÔÚ½ÓÊܵÚÈý´úEGFR-TKIÖÎÁÆÊ§°Ü£¨HR 0.48, 95% CI 0.35-0.66£©¡¢¡¢¡¢»ùÏßÓÐÄÔ×ªÒÆ£¨HR 0.40, 95% CI 0.22-0.73£©¡¢¡¢¡¢EGFRÍ»±äΪ19ºÅÍâÏÔ×Óȱʧ£¨HR 0.48, 95% CI 0.32-0.73£©ÒÔ¼°T790MÍ»±äÑôÐÔ£¨HR 0.22, 95% CI 0.09-0.54£©µÄ»¼ÕßÑÇ×éÖУ¬£¬ÒÀÎÖÎ÷µ¥¿¹ÁªºÏ·½°¸¾ùÏÔʾ³öÎÞÏ£ÍûÉúÑÄÆÚ»ñÒæÓÅÊÆ¡£

FB33F1E28CB60D6BFDBFB3E78FC_E165BCDE_13EFF

ÒâÏòÖÎÁÆÈËȺ£¨ITT£©µÄÎÞÏ£ÍûÉúÑÄÆÚ

70D2EA321757B4782507D8D9C6B_24D11439_C8DE

ÄÔ×ªÒÆ»¼ÕßµÄÎÞÏ£ÍûÉúÑÄÆÚ

C6717E309B53BCD8D44478BE2A0_7A45F8E6_1494B

²»°éÓÐÄÔ×ªÒÆ»¼ÕßµÄÎÞÏ£ÍûÉúÑÄÆÚ

6A884613CEA940C5F807BE4C33E_1B6BBB55_19A6B

HARMONi-A·½°¸µÄ»ñÒæÓÅÊÆ

»º½âÂʸü¸ß£¬£¬ºã¾Ã»ñÒæÊÆÏÔ×Å

ÒÀÎÖÎ÷µ¥¿¹ÁªºÏ»¯ÁƱÈÕÕ»¯ÁÆ×éµÄ¿Í¹Û»º½âÂÊ£¨ORR£©Îª50.6%£¨95% CI 42.6-58.6£©ºÍ35.4%£¨95% CI 28.0-43.3£©¡£×èÖ¹2023Äê12Ô£¬£¬ÖÐÎ»Ëæ·Ãʱ¼äΪ17.6¸öÔ£¬£¬ÒÀÎÖÎ÷ÁªºÏ·½°¸ÖÐλ×ÜÉúÑÄÆÚΪ17.1¸öÔ£¬£¬±ÈÕÕ×éÖÐλÉúÑÄÆÚΪ14.5¸öÔ£¬£¬½µµÍéæÃü·çÏÕ20%£¨HR 0.8£¬£¬95% CI: 0.59 ~1.08£©¡£Ãô¸ÐÐÔÆÊÎöÏÔʾ£¬£¬ÒÀÎÖÎ÷µ¥¿¹ÁªºÏ·½°¸×éÊӲ쵽ÉúÑÄÆÚÓÐÏÔ×ÅÑÓÉìÇ÷ÊÆ£¬£¬½µµÍéæÃü·çÏÕ23%£¨HR 0.77£¬£¬95% CI: 0.56 ~1.07 £©¡£

BE26B05DE99F0CDBCA043200A47_A149E406_29BD6

OSÉúÑÄÇúÏßͼ

Ñо¿Ð§¹ûÅú×¢£¬£¬HARMONi-A·½°¸ÕûÌåÇå¾²¿É¿Ø£¬£¬Á½×é¼ä³£¼û²»Á¼·´Ó³±¬·¢ÂÊÎÞÏÔ×Ųî±ð¡£Á½×éµÄÖÎÁÆÊ±´ú·ºÆðµÄ²»Á¼·´Ó³£¨TEAE£©±¬·¢ÂÊ»®·ÖΪ61.5%ºÍ49.1%£¬£¬ÆäÖÐ×î³£¼ûµÄΪ»¯ÁÆÏà¹Ø²»Á¼ÊÂÎñ¡£¡Ý3¼¶ÃâÒßÏà¹Ø²»Á¼ÊÂÎñ£¨irAE£©±¬·¢ÂÊ»®·ÖΪ6.2%ºÍ2.5%£»£»£»¡Ý3¼¶VEGFÏà¹Ø²»Á¼ÊÂÎñ±¬·¢ÂÊΪ3.1%ºÍ2.5%¡£

ÂÛÎÄÁ´½Ó£º£ºhttps://pubmed.ncbi.nlm.nih.gov/38820549/

¡¾ÍøÕ¾µØÍ¼¡¿