Deepness analyses immunity cure is effective, invalid and poisonous forum of tumour of difficulty of

Share a text that treats effective crowd, invalid crowd and poisonous crowd to analyse about immunity, this article originates " jewel seeking drug " , original title: Forum of tumour of long march difficulty | Professor Cai Xiuyu analyses immunity bitingly cure is effective, invalid, poisonous 3 large crowds

Before before long, the whole nation the 3rd " forum of tumour of long march difficulty " hold grandly in Shanghai, this the conference does sth unconventional or unorthodox, sword sharp edge points to clinical difficulty tumour continuously this one tall sharp a hard nut to crack, put forward " basket is academic " reach " gene measures order " break through direction for what direct. The conference burst forth the research direction of hot water of treatment of tumour of difficulty of many sided breakthrough and clinical practice experience, zhongshan university Cai Professor Xiu Yu points out, immune cure development is fervent, because of its distinctive action mechanism, plant in extensive tumour very big effect is produced in cure, the topic of the speech that Professor Cai shares below, immune cure and basket theory think.

Professor Cai points out, at present a gleam of of I/O only drug or second line treat each big cancer is planted curative effect still owes beautiful, in a few big common cancer is planted in, a gleam of of blame cellule lung cancer is businesslike 45% , cure of the line after liver cell cancer is businesslike have 20% only, cure of the line after cancer of the stomach is businesslike have 17% only.

To this, cai Jiao awards to treating a crowd choose put forward 3 think greatly: How to choose the crowd with immune effective depressor? Perhaps choose invalid crowd? If condition of the economy in patient home is better, without giving thought to effective, want to try immune cure, so how to choose poisonous crowd?

The curative effect with immune common depressor evaluates index to PDL1 conveys level, TMB level, DMMR/MSI-H level to wait.

Professor Cai points out, consider to be able to discover according to Keynote -042, convey a level to PDL1 (PDL1 ≥ 50% ) patient, k medicine (sheet fights Pabolizhu) only drug curative effect relatively change cure to have apparent promotion (in PFS is 10.3 months respectively: 6 months) , PDL1 level may be calculate index well, but also put in the problem. For instance crowd of PDL1 expression negative is restrained to immunity still have answer, PDL1 detects the level also is put in certain otherness, because take constituent confine, inside tumour may present a different result with the organization outside tumour.

TMB bear and immunity are treated also be closely bound up, checkmate026 considers to point out, the patient of tall TMB uses O drug (accept fierce sheet is fought) the effect is better than changing cure, and the patient curative effect of low TMB owes beautiful.

Cai Jiao is awarded also the research related the basis, summed up the feature of patient of a few tall TMB: If male patient compares female patient,crowd of tall, smoking compares TMB not to smoke the crowd is fast, TMB of patient of cancer of neck of lung cancer, palace, colonic cancer is taller.

Final summary arrives, it is better that PDL1 combines TMB to forecast the result, pointed out the influencing factor of other possibility at the same time, curative effect of therapy of immunity of the person that if bleb is ill,virus of poison, HPV, EBV is affected may be better, and curative effect of second liver patient is poorer.

Treat the exploration of invalid crowd to immunity, research discovers immunity of the following crowd treats curative effect to owe beautiful:

Patient of MET EX14 skip obtains PD1/PDL1 to treat benefit less

JAK mutation can bring about immunity to treat resistance

Curative effect of PD-1 of PTEN mutation patient is poorer

Liver transfers the patient's curative effect to also owe beautiful, experiment according to Checkmate-017/057, in group of drug of O of liver move patient OS is form of contest of 1.8 months, much sitar to be 1.5 months, and analysis of all patient collect discovers O drug group is medium OS is form of contest of 2.8 months, much sitar to be 2.1 months. Although immunity treats cure heterodyne, but liver move patient can pass local treatment (put cure, intervene) or fight hemal medication liver to change kitchen range.

To having the patient of oneself immunity disease, professor Cai is summed up, this part patient and other patient are overall curative effect comparatives, the undesirable reaction that produce is similar also, aggravating proportion is small, but the patient that needs close attention to have fundamental immunity disease uses immunity to treat.

Use the multitude that immunity treats to wanting to try, the most important is need after eliminating these patients to use immunity to treat, can happen exceed progress, to this, professor Cai is summed up, the following crowd is incidental exceed progress:

MDM2 familial enlarge adds a patient easy happening exceed progress;

DNMT3A choppy patient is easy happen erupt type makes progress;

11q13 chromosome enlarge adds a patient easy happening exceed progress

Professor Cai analysed what immunity treats to be benefited for us, invalid, poisonous 3 adult group, in floating tumour is planted, immune cure will produce decisive effect, can coach this part crowd undertakes immunity is treated better so. Finally, professor Cai is summed up, immune cure says with its is " provide timely help " , actually " perfect " more apt, this need patient has certain oneself immunity capacity, play of such immune cure ability give bigger effect.

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