2016年post-asco会后Meteor研究结果尼对照依维莫斯治疗mRCC

杭州市肿瘤医杭州市肿瘤医肿瘤内主要内上皮癌：IMvigorstudy（#4500,Atezolizumab治疗mUC肾癌：#4506,Meteor研究更新结果（卡博替尼对照依维莫斯治疗Nivolumab治疗mRCC长期随访结癌PRINCE研究多西他赛间歇疗法对持续疗法在CRPC的研主要内上皮癌：IMvigorstudy（#4500,Atezolizumab治疗mUC肾癌：#4506,Meteor研究更新结果（卡博替尼对照依维莫斯治疗Nivolumab治疗mRCC长期随访结PRINCE研究多西他赛间歇疗法对持续疗法在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 铂类由于PS评分只接的生存获 吉西他滨+卡铂：ORR:36%，mOS:9.3m，21%患者因为毒性而中 PresentedByArjunBalarat2016ASCOAnnualPresentedByArjunBalarat2016ASCOAnnualPresentedByArjunBalarat2016ASCOAnnualPresentedByArjunBalarat2016ASCOAnnual PresentedByArjunBalarat2016ASCOAnnualPresentedByArjunBalarat2016ASCOAnnual有效者包龄、肾功能差、PresentedByArjunBalarat2016ASCOAnnualPresentedByArjunBalarat2016ASCOAnnualPresentedByArjunBalarat2016ASCOAnnualPresentedByArjunBalarat2016ASCOAnnualPresentedByArjunBalarat2016ASCOAnnualPresentedByArjunBalarat2016ASCOAnnual不能耐受顺铂治疗的转移性泌尿上皮癌Atezolizumab一线治疗有持久的反应所 Atezolizumab可耐受，治疗相关3/4级毒性和因为AE终止均比较PresentedByArjunBalarat2016ASCOAnnualPresentedByRobertDreicerat2016ASCOAnnual Atezolizumab是第一个被FDA加速批准治疗mUC的PD-L1抑制剂（2016.5.18治疗后疾病进展局部晚期或转移性泌尿上皮PresentedByRobertDreicerat2016ASCOAnnualPresentedByRobertDreicerat2016ASCOAnnualPresentedByRobertDreicerat2016ASCOAnnualPresentedByRobertDreicerat2016ASCOAnnualPresentedByRobertDreicerat2016ASCOAnnual外的CR和5个2个PresentedByRobertDreicerat2016ASCOAnnualPresentedByRobertDreicerat2016ASCOAnnualPresentedByRobertDreicerat2016ASCOAnnualPresentedByRobertDreicerat2016ASCOAnnualPresentedByRobertDreicerat2016ASCOAnnualtezolizab第一个被FDD1PD1FDA批准基于对曾经治疗过、预后差的转移性泌尿上皮癌有较好的临床反应PD-L1状态所有亚组均有疗效，但高表长期随访中可发现新的客观反应及额外随机Ⅲ期临床研究对比化疗正在进行（IMvigor211; PresentedByRobertDreicerat2016ASCOAnnual主要内上皮癌：IMvigorstudy（#4500,Atezolizumab治疗mUC肾癌：#4506,Meteor研究更新结果（卡博替尼对照依维莫斯治疗Nivolumab治疗mRCC长期随访结癌PRINCE研究多西他赛间歇疗法对持续疗法在CRPC的研晚期肾癌治疗概细胞因子治疗mPFS3-5月，mOS最多17靶向治疗mOS高达29TKI药物和mTOR抑制剂为标准1线和2线治−−mTOR抑制剂依维莫斯受卡博替尼、PD-1抑制剂晚期肾癌 评估MSKCC标PresentedByToniChoueiriat2016ASCOAnnualPresentedByToniChoueiriat2016ASCOAnnualCabozantinibCabozantinib是针对包括MET,VEGFR,AXL等信号位点酪氨酸酶抑制Ⅱ期随机临床研究Cabosun试验显示，未治疗的RCC患者中，CabozantinibSunitinib具有显著延长Ⅲ期随机临床研究METEOR试验，曾经接受VEGRTKI治疗后RCC，中位PFS：Cabozantinib7.4m对比Everolimus3.8m，HR−PresentedByToniChoueiriat2016ASCOAnnual每8每8PresentedByToniChoueiriat2016ASCOAnnualPresentedByToniChoueiriat2016ASCOAnnualPresentedByToniChoueiriat2016ASCOAnnualPresentedByToniChoueiriat2016ASCOAnnualPresentedByToniChoueiriat2016ASCOAnnualPresentedByToniChoueiriat2016ASCOAnnualPresentedByToniChoueiriat2016ASCOAnnualPresentedByToniChoueiriat2016ASCOAnnualPresentedByToniChoueiriat2016ASCOAnnualPresentedByToniChoueiriat2016ASCOAnnual此次更新的结果与既 卡博替尼和依维莫斯常见的 −卡博替尼组：腹泻75%，乏力 −依维莫斯组：乏力48%，贫血39%，纳差35%，咳嗽34%，气促治疗相关性AE均可以通过剂量调整减由于AE导致药物中断卡博替尼12%，依维莫斯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期临床研究CheckMate025研究提示，对于曾经行抗血管治疗的转移性Nivolumab比较Everolimus有显著延长 本次数据是分析Ⅰ、Ⅱ期Nivolumab研究中随访超过4年的患者的生存期和安全PresentedByDavidMcDermottat2016ASCOAnnual治疗持续：若SD治疗至96主要：安治疗持续：若SD持续治终点次要：ORR,OS，毒PresentedByDavidMcDermottat2016ASCOAnnualPresentedByDavidMcDermottat2016ASCOAnnualPresentedByDavidMcDermottat2016ASCOAnnualPresentedByDavidMcDermottat2016ASCOAnnualPresentedByDavidMcDermottat2016ASCOAnnualPresentedByDavidMcDermottat2016ASCOAnnualPresentedByDavidMcDermottat2016ASCOAnnualPresentedByDavidMcDermottat2016ASCOAnnualPresentedByDavidMcDermottat2016ASCOAnnualPresentedByDavidMcDermottat2016ASCOAnnualPresentedByDavidMcDermottat2016ASCOAnnual这是PD-1/PD-L1抑制剂治疗 的随访最长数Nivolumab二线或多线治疗aRCC数据提−约有1/3患者有4年生存（Ⅰ期和Ⅱ期），5年生存（Ⅰ期 −安全性与既 类似，大部分治疗相关AE常常在6月PresentedByDavidMcDermottat2016ASCOAnnualNext确确保PD-1抑制剂在mRCC的应用以增加有效−明确长期生存预测因−优化治疗持续时−更新临床研究试验设计，探索序贯次序、辅助及联合治疗对临床预的影PresentedByDavidMcDermottat2016ASCOAnnual主要内上皮癌：IMvigorstudy（#4500,Atezolizumab治疗mUC肾癌：#4506,Meteor研究更新结果（卡博替尼对照依维莫斯治疗Nivolumab治疗mRCC长期随访结癌PRINCE研究多西他赛间歇疗法对持续疗法在CRPC的研PresentedByHannesCashat2016ASCOAnnual间歇疗法理论基享受治疗假期-减少多西紫杉-没有数据证明非劣PresentedByHannesCashat2016ASCOAnnualPresentedByHannesCashat2016ASCOAnnualPresentedByHannesCashat2016ASCOAnnualPresentedByHannesCashat2016ASCOAnnualPresentedByHannesC