Caspian research has released new data: persistence for 12 weeks, you will see a different effect

*For medical professionals for reading reference

Focus on the latest research data of 2022 WCLC -Caspian.

The World Health Organization International Cancer Research Agency (IARC) released the latest global cancer burden data released in 2020 shows that lung cancer is the most incidence and mortality in my country with the highest incidence and mortality. [1] Small cell lung cancer (SCLC) is a strong type of lung cancer subtype, which accounts for 15 % -20 % of lung cancer [2]. In SCLC, SCLC is most common in a wide range, accounting for about 70 %. Although the initial relief rate of first -line chemotherapy schemes is high, most patients are prone to drug resistance and even quickly recur, resulting in a poor prognosis of patients with a wide range of SCLC, with a median survival of only about 10 months [3].

The emergence of immunotherapy injects fresh blood into the treatment of SCLC, effectively extending the patient's survival. The Caspian Study [4] data published in the 2019 "Liu Ye Dao" magazine shows the long survival benefit of PD-L1 inhibitory doses of daeumab combined with chemotherapy. At the subsequent 2021 European Decele Medicine Society (ESMO), the three -year OS data of the study was announced. Long survival data. Then which patients can survive for 3 years and whether there are predictive indicators, which can help clinicians judge the prognosis of SCLC patients' use of Pattiumab, which has become a general concern for everyone.

Recently held a recent analysis of the last analysis of Caspian research on the 2022 World Lung -Cancer Conference (WCLC). This research has explored the survival prediction indicators of the wide period of SCLC, and found that patients who obtained tumor relief at 12 weeks of treatment were tumor. The survival of Lidazab's combination of chemotherapy is even greater [6].

On the occasion of this conference, Professor Dong Xiaorong, a "medical community" invited the Huazhong University of Science and Technology Cancer Center, announced the latest data of Caspian research on the 2022 WCLC period to share and discuss.

Explore the research data of Caspian in depth, find a wide range of SCLC long survival prediction indicators

Caspian Research [5] is a random, open, and global multi -center phase III clinical study. It explores the combination of du Liyu combined with Polycin and platinum chemotherapy (D+EP). The efficacy and safety of SCLC patients who have not been treated in the past have not been treated in the past.

The study included 805 patients with a wide range of SCLC patients, and random groups received D+EP treatment and separate EP therapy. The results of the study show that patients receiving D+EP have a better general survival (OS) and no progressive survival (PFS), and the proportion of tumors is higher. However, the degree of tumor reduction is unclear whether the OS and PFS of the patient's OS and PFS are related.

Based on this, the researchers at different time points (6, 12, 20 weeks) after the treatment of patients in Caspian research, and the patients survived the patients into respondents based on the RECIST V1.1 standard evaluated by the researchers (completely or partial tumors were reduced) And the non -responding response (the tumor is not reduced), the difference between the respondent and the response from the response at different time points.

Researchers conducted PFS and OS Landmark analysis of Caspian's research to January 2020. The 6, 12, and 20 weeks use the Kaplan-MEIER method to evaluate the respondents and the OS and PFS differences of non-respondants.

时 1. Tumor relief at 12 weeks can be used as a good indicator for predicting OS and PFS

The results of the study [5] showed that among the patients who survived at 12 weeks, the proportion of response in the D+EP group was higher than the EP group (Figure 1) compared with the EP group (Figure 1).

Figure 1. The proportion of respondents at the D+EP group and EP group at 12 weeks

Compared with the response at 12 weeks, the OS and PFS responders in the D+EP group are longer, but the OS and PFS incident observed by the D+EP group are less (Table 1, Table 2).

Table 1. OS difference between the respondent and the non -respondent

Table 2. PFS difference between response and non -respondent

In order to further understand the OS rate and PFS rate of respondents and non-respondants at the 12th week of the treatment, the researchers performed the Kaplan-Meier analysis of OS and PFS based on the response status of the patient in the 12th week, and drawing the survival curve (Figure 2 2 (Figure 2 2 ,image 3).

In D+EP group (Figure 2):

The 2 -year OS rate of the respondent is: 35.4%(95%CI: 25.8%-45.1%);

The 2 -year OS rate of non -response is 9.0%(95%CI: 4.7% -15.2%).

In EP group (Figure 3):

The 2 -year OS rate of the respondent is 9.4%(95%CI: 4.1%-17.3%);

The 2 -year OS rate of non -response is: 8.4%(95%CI: 3.2%-16.7%).

In each treatment group, the OS rate and PFS rate of respondents are significantly higher than those who do not respond (the OS and PFS of each treatment group are P <0.001).

In addition, the analysis of the multi -variable model found that the relief in the 12th week (P value of OS and PFS <0.001) and the interaction items for treatment and relief (used to measure the impact of the alleviation between the D+EP group and the EP group on the survival period Different; the P value of OS is 0.023, and the P value of PFS is 0.004), which are significantly related to the longer OS and PFS. Figure 2. The Kaplan-Meier curve of the respondent and the OS without respondent at the D+EP group for 12 weeks

Figure 3. The Kaplan-Meier curve of the AS respondent and the OS without response at the EP group

The study also found that compared with the respondent who received EP therapy, the possibility of responders who received D+EP treatment during the follow-up period were significantly reduced [OS's HR = 0.56 (95%: 0.41-0.77), and PFS's HR = 0.59 (95%: 0.44-0.79)] (Table 3), once again verified the treatment scheme of Diagaruki combined chemotherapy to the patient's survival.

Table 3. During the follow -up period, the possibility of OS and PFS incidents in the D+EP group and EP group responders and those without answers

和 2. Tumor relief at 6 weeks and 20 weeks also has good long -term survival prediction value

Sensitive analysis found that the data observed in 6 weeks and 20 weeks are similar to 12 weeks. The relief of the three time points is significantly positive with the OS and PFS of the two treatment groups. The relief of 12 and 20 weeks may be a good indicator for long -term survival of patients with SCLC in a wide range.

However, 12 weeks represent the time point of induced chemotherapy in Caspian research. The C-Inndex index based on OS and PFS is based on the 12 weeks of display time points.

summary:

Caspian research continues to give surprising data, and the treatment plan for Dagurimabicopic Kye Chemotherapy has been effectively verified by the significant effect of SCLC in a wide range of SCLC, and further exploration of different time points in the treatment process has clinical treatment. Deeper guiding significance. The side effects of malignant tumor therapy drugs and the difficulty of the treatment of SCLC in a wide range of SCLC may all make patients degraded, and it is prone to premature changes and even abandon treatment. The predictive data prediction data gives patients psychological comfort and confidence in treatment, which can also prolong the overall survival of the patient.

Therefore, when the clinical use of Dagaru Uluming combined with the extensive period of SCLC, if the efficacy is uncertain, it may be possible to adhere to the possibility of subsequent long -term survival benefits according to the tumor relief situation, and then then Decide whether to continue treatment. This will not only allow patients to avoid unnecessary treatment, but also avoid the opportunity to miss the longer OS and PFS.

Expert Introduction

Professor Dong Xiaorong

Three -level professor, chief physician, doctoral supervisor

Deputy director

Director of the Department of chest and oncology at the Cancer Center of China University of Science and Technology

Director of China Clinical Oncology Society

Deputy Chairman of the China Pharmaceutical Education Association of the Lungs and Tumor Specialty Committee of the China Medical Education Association

Standing Committee Member of the China Anti -Cancer Association Lung Cancer Expert Committee

Standing Committee Member of the Chinese Clinical Oncology Society of Immunohistan

Standing Committee Member of the China Clinical Oncology Society

Standing Committee of the Education Expert Committee of the China Clinical Oncology Society

Member of the China Clinical Oncology Society of Non -Cell Cancer Cancer

Chairman of the Hubei Anti -Cancer Association Tumor Immunotherapy Committee

Deputy Chairman of the Hubei Provincial Anti -Cancer Association Cancer Internal Medicine Special Committee

references:

[1] SUNG H, FerlayJ, Siegel Rl, et al. Global Cancer Statistics 2020: Globocan Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 COUNTRIES. CA CANCER J Clin.

[2] Zhu Linxiao, Li Youlun. The clinical research status of the immune examination point inhibitor in the treatment of small cell lung cancer [J]. Clinical pulmonary magazine, 2020, 25 (5): 788-793.

[3] Liu Guoqiang, Kang Shuo. Adi-Aidabi Mipido combined standard chemotherapy plan for the treatment of a wide range of small cell lung cancer-effective analysis [J]. China Pharmacy 2021 Vol. 32, Issue 1.

Results from a randomised, Controlled, Open-Label, Phase 3 TRIAL. Lancet Oncol (2021) 22 (1): 51–65. Doi: 10.1016/S1470-2045 (20) 30539-8. [5] l. Paz-

[6] s. Johal, C. Fischer, et al. WCLC 2022 Poster EP14.04-002.

*This article is only used to provide scientific information to medical people, and does not represent the viewpoint of this platform

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