Immunological checkpoint blocking antibodies are currently the most advanced new anticancer agents. The PD-1/PD-L1 antibody exhibits significant antitumor activity by restoring an effective response against tumor T cells. Therefore, such drugs are approved for the treatment of various types of tumors. However, the latest study found that PD-1 / PD-L1 antibody will accelerate the tumor growth rate of some cancer patients. In a recent issue of the Lancet magazine, French researchers Champiat et al found that patients over 65 years of age experienced rapid progression of tumors during PD-1/PD-L1 monoclonal antibody treatment, and overall survival rate was higher. difference. The researchers analyzed data from 218 patients who underwent clinical phase I multiple tumor trials between December 2011 and January 2014. According to the Solid Tumor Response Assessment Criteria (RECIST): 49 (37%) / 131 patients with accelerated progression, 66 (50%) stable, 15 (12%) partial response, 1 (1%) complete response. 12 (9%) had a disease progression response according to the RECIST evaluation criteria. The rate of solid tumor growth is twice or even more between baseline and treatment. 7 (19%) / 36 patients over 65 years of age had overspeed progression, while the corresponding group under 64 years of age, 5 (5%) / 95 cases (p = 0.018) showed super progress, and the overall median survival was also short (12 patients, median survival 4.6 months, 95% CI 2.0-unable to obtain), corresponding non-super-advanced patients: 119 patients, survival 7.6 months, 95% CI 5.9-16), although statistically no significant The difference (p = 0.18). However, in the initial assessment, the frequency of new lesions in super-progress patients was 33%, which was significantly lower than that in patients without super-progression (84%, p=0.0019). 1. Distribution of the first tumor evaluation results after PD-1 / PD-L1 antibody treatment. 18 (8%) and 5 (2%) patients were discontinued due to clinical progression and toxicity before the first tumor evaluation, 27 were excluded due to incomplete data, and 35 were excluded because the reference period was too short or too long. . Therefore, only 131 cases were able to perform effective TGR analysis. According to the RECIST criteria (Evaluation criteria for solid tumors), 49 (37%) 66 (50%) 15 (12%) and 1 (1%) patients showed progressive disease and stable disease, respectively. ), partial response, complete response.
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