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PD-1/PD-L1 Inhibitor Plus Chemotherapy Versus PD-1/PD-L1 Inhibitor in Microsatellite Instability Gastrointestinal Cancers: A Multicenter Retrospective Study

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作者：
Chen Mifen[1] ; Wang Zhenghang[1] ; Liu Zimin[2] ; Deng Ting[3] ; Wang Xiaodong[4] ; Chang Zhiwei[5] ; Zhang Qi[1] ; Yang Wenlei[6] ; Liu Ning[2] ; Ji Zhi[3] ; Zhang Xiaotian[1] ; Wang Xicheng[1] ; Peng Zhi[1] ; Li Yi[5] ; Cao Yujuan[4] ; Jin Xuan[7] ; Lu Hongxia[8] ; Qu Huajun[9] ; Tang Yong[10] ; Xu Chunlei[10] ; Fang Weijia[11] ; Zhang Hangyu[11] ; Yan Dong[12] ; Wang Li[12] ; Li Jiayi[13,14] ; Zhang Jingdong[15] ; Wang Qiwei[15] ; Xue Liying[16] ; Yin Fei[17] ; Han Guangjie[17] ; Cheng Zhiqiang[18] ; Liu Qing[18] ; Jin Yongdong[19] ; Zhang Yinjie[19] ; Li Lanxing[19] ; Cao Baoshan[20] ; Yao Yanhong[20] ; Chen Zhiyu[21] ; Zou Jianling[21] ; Ying Jieer[22] ; Wei Qing[22] ; Tian Tiantian[23] ; Zhao Weifeng[24] ; Li Longmei[25] ; Zhang Tong[26] ; Song Fanghua[27] ; Ba Ya-Er[28] ; Li Na[29] ; Gao Hui[30] ; Ji Yinghua[31] ; Bao Liying[32] ; Zhao Xiaochen[33] ; Cai Jinping[33] ; Yuan Zheping[33] ; Shen Lin[1] ; Li Jian[1,*1] ;
机构： [1]Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing, China. [2]Department of Oncology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China. [3]Department of Gastrointestinal Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China. [4]Department of Oncology, Peking University Shougang Hospital, Beijing, China. [5]Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China. [6]Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing, China. [7]Department of Medical Oncology, Peking University First Hospital, Beijing, China. [8]Department of Gastroenterology, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi, China. [9]Department of Medical Oncology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China. [10]Department of Digestive Internal Medicine, The Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China. [11]Department of Medical Oncology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China. [12]Department of Oncology, Beijing Luhe Hospital Affiliated to Capital Medical University, Beijing, China. [13]Department of Medical Oncology, The First Affiliated Hospital of Xiamen University, Xiamen, China. [14]School of Medicine, Xiamen University, Xiamen, China. [15]Medical Oncology Department of Gastrointestinal Cancer, Liaoning Cancer Hospital & Institute, Cancer Hospital of China Medical University, Shenyang, China [16]Department of Medical Oncology, People's Hospital of Inner Mongolia Autonomous Region, Hohhot, Inner Mongolia, China. [17]Department of Gastroenterology and Hepatology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China. [18]Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing, China. [19]Department of Medical Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China. [20]Department of Medical Oncology and Radiation Sickness, Peking University Third Hospital, Beijing, China. [21]Department of Gastrointestinal Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China. [22]Department of Abdominal Medical Oncology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, Zhejiang, China. [23]Department of Oncology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China. [24]Department of Oncology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, People's Hospital of Henan University, Zhengzhou, Henan, China. [25]Department of Oncology, Guangdong Provincial Hospital of Chinese Medicine, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China. [26]Department of Oncology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China. [27]Department of Oncology, Dalian University Affiliated Xinhua Hospital, Dalian, Liaoning, China. [28]Department of Internal Medicine, Baotou Cancer Hospital, Baotou, Inner Mongolia, China. [29]Cancer Center, Suining Central Hospital, Suining, Sichuan, China. [30]Department of Oncology Rehabilitation, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China. [31]Department of Oncology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China. [32]Department of Medical Oncology, Manzhouli People's Hospital, Manzhouli, Inner Mongolia, China. [33]Medical Affairs, 3D Medicines, Inc, Shanghai, China.
出处：
DOI： 10.1200/PO.22.00463
ISSN：

摘要：
To investigate the efficacy of PD-1/PD-L1 inhibitors plus chemotherapy versus anti-PD-1/PD-L1 monotherapy in advanced microsatellite instability (MSI)/mismatch repair-deficient (dMMR) gastrointestinal cancers.We retrospectively recruited patients with MSI/dMMR gastrointestinal cancer who received anti-PD-1/PD-L1 with or without chemotherapy and compared objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS) of PD-1/PD-L1 inhibitor plus chemotherapy (chemo-anti-PD-1/PD-L1 group) and PD-1/PD-L1 inhibitor alone (anti-PD-1/PD-L1 group). Propensity score-based overlap weighting analysis was conducted to adjust the baseline covariable imbalance. Sensitivity analysis was performed to confirm the stability of the results by propensity score matching and multivariable Cox and logistic regression models.A total of 256 patients were eligible, with 68 and 188 receiving chemo-anti-PD-1/PD-L1 and anti-PD-1/PD-L1, respectively. The chemo-anti-PD-1/PD-L1 group showed significant improvements versus the anti-PD-1/PD-L1 group in ORR (61.8% v 38.8%; P = .001), DCR (92.6% v 74.5%; P = .002), PFS (median PFS [mPFS], not reached [NR] v 27.9 months; P = .004), and OS (median OS [mOS], NR v NR; P = .014). After overlap weighting, the improvements tended to be more significant with chemo-anti-PD-1/PD-L1 versus anti-PD-1/PD-L1 in ORR (62.5% v. 38.3%; P < .001), DCR (93.8% v 74.2%; P < .001), PFS (mPFS, NR v 26.0 months; P = .004), and OS (mOS, NR v NR; P = .010). These results were solidified through sensitivity analysis.Chemo-anti-PD-1/PD-L1 is superior to anti-PD-1/PD-L1 in MSI/dMMR gastrointestinal cancers with improved efficacy.

基金：
National Natural Science Foundation of China (No. 91959130), the Beijing Municipal Natural Science Foundation (No. 7224323), the National Natural Science Foundation of China (No. 81902514), and the Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support (ZYLX202116).
语种：
外文
被引次数：
WOS：
PubmedID：
中科院(CAS)分区：
出版当年[2023]版：
大类 | 2 区 医学
小类 | 3 区 肿瘤学
最新[2023]版：
大类 | 2 区 医学
小类 | 3 区 肿瘤学
JCR分区：
出版当年[2023]版：
Q1 ONCOLOGY
最新[2023]版：
Q1 ONCOLOGY

影响因子： 最新[2023版] 最新五年平均 出版当年[2023版] 出版当年五年平均 出版前一年[2022版]

第一作者：
第一作者机构： [1]Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing, China.
共同第一作者：
通讯作者：
通讯机构： [1]Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing, China. [*1]Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Oncology, Peking University Cancer Hospital & Institute, 52 Fucheng Rd, Haidian District, Beijing 100142, China
推荐引用方式(GB/T 7714)：
Chen Mifen,Wang Zhenghang,Liu Zimin,et al.PD-1/PD-L1 Inhibitor Plus Chemotherapy Versus PD-1/PD-L1 Inhibitor in Microsatellite Instability Gastrointestinal Cancers: A Multicenter Retrospective Study[J].JCO PRECISION ONCOLOGY.2023,7:e2200463.doi:10.1200/PO.22.00463.
APA：
Chen Mifen,Wang Zhenghang,Liu Zimin,Deng Ting,Wang Xiaodong...&Li Jian.(2023).PD-1/PD-L1 Inhibitor Plus Chemotherapy Versus PD-1/PD-L1 Inhibitor in Microsatellite Instability Gastrointestinal Cancers: A Multicenter Retrospective Study.JCO PRECISION ONCOLOGY,7,
MLA：
Chen Mifen,et al."PD-1/PD-L1 Inhibitor Plus Chemotherapy Versus PD-1/PD-L1 Inhibitor in Microsatellite Instability Gastrointestinal Cancers: A Multicenter Retrospective Study".JCO PRECISION ONCOLOGY 7.(2023):e2200463

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