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PD-1单克隆抗体治疗实体器官移植术后恶性肿瘤的系统评价

宾阳阳 李杰群 李强 周政俊 周依 陈广顺 齐海智 司中洲

宾阳阳, 李杰群, 李强, 等. PD-1单克隆抗体治疗实体器官移植术后恶性肿瘤的系统评价[J]. 器官移植, 2020, 11(3): 384-390. doi: 10.3969/j.issn.1674-7445.2020.03.011
引用本文: 宾阳阳, 李杰群, 李强, 等. PD-1单克隆抗体治疗实体器官移植术后恶性肿瘤的系统评价[J]. 器官移植, 2020, 11(3): 384-390. doi: 10.3969/j.issn.1674-7445.2020.03.011
Bin Yangyang, Li Jiequn, Li Qiang, et al. Systematic evaluation on PD-1 monoclonal antibody in the treatment of malignant tumor after solid organ transplantation[J]. ORGAN TRANSPLANTATION, 2020, 11(3): 384-390. doi: 10.3969/j.issn.1674-7445.2020.03.011
Citation: Bin Yangyang, Li Jiequn, Li Qiang, et al. Systematic evaluation on PD-1 monoclonal antibody in the treatment of malignant tumor after solid organ transplantation[J]. ORGAN TRANSPLANTATION, 2020, 11(3): 384-390. doi: 10.3969/j.issn.1674-7445.2020.03.011

PD-1单克隆抗体治疗实体器官移植术后恶性肿瘤的系统评价

doi: 10.3969/j.issn.1674-7445.2020.03.011
基金项目: 

国家自然科学基金 81102241

湖南省自然科学基金 2018JJ2561

详细信息
    作者简介:

    宾阳阳,女,1994年生,硕士,住院医师,研究方向为器官移植和普通外科,Email:byy123@csu.edu.cn

    通讯作者:

    司中洲,男,1970年生,博士,副主任医师,研究方向为器官移植和普通外科,Email:sizhongzhou@csu.edu.cn

  • 中图分类号: R617, R730.5

Systematic evaluation on PD-1 monoclonal antibody in the treatment of malignant tumor after solid organ transplantation

More Information
  • 摘要:   目的  探讨实体器官移植(SOT)术后使用程序性细胞死亡受体-1(PD-1)单克隆抗体(单抗)治疗恶性肿瘤的有效性和安全性。  方法  检索7个数据库中的相关文献。收集54例SOT受者术后使用PD-1单抗治疗恶性肿瘤的案例,对使用PD-1单抗的SOT受者的临床效果及排斥反应情况进行分析。  结果  共纳入符合标准的文献32篇,共54例SOT受者。其中男43例,女11例,年龄为14~79岁。包括29例肾移植受者、19例肝移植受者、6例心脏移植受者。SOT受者使用的PD-1单抗药物类型包括28例使用派姆单抗、26例使用纳武单抗。PD-1单抗治疗SOT受者术后恶性肿瘤的总体缓解率为32%(17/54),疾病进展率44%(24/54),病死率为36%(19/54)。PD-1单抗治疗SOT受者术后恶性肿瘤后,排斥反应发生率为39%(21/54)。排斥反应与PD-1单抗药物类型无明显相关性(P > 0.05)。  结论  PD-1单抗能有效治疗SOT受者术后恶性肿瘤,治疗过程中可引发排斥反应,但排斥反应并不是导致受者死亡的最常见原因。

     

  • 表  1  纳入文献的基本信息

    Table  1.   Basic information of the included literatures

    例序 年龄
    (岁)

    移植
    移植适应证 恶性肿瘤
    类型
    PD-1单抗
    类型
    其他抗
    肿瘤治疗
    免疫抑制方案 排斥
    反应
    临床
    效果
    结局
    1[7] 48 原发性肝癌 肝癌 派姆单抗 FK506+SRL NE 存活
    2[8] 70 原发性肝癌 肝癌 派姆单抗 FK506 PD 死亡
    3[9] 57 原发性肝癌 肝癌 派姆单抗 SRL+FK506+泼尼松 CR 存活
    4[10] 35 胆道闭锁 MM 派姆单抗 FK506 CR 存活
    5[11] 63 - MM 派姆单抗 环孢素 NE 死亡
    6[12] 46 药物中毒 MM 派姆单抗 SRL PD 死亡
    7[13] 62 原发性肝癌 MM 派姆单抗 SRL+MMF PR 存活
    8[14] 55 原发性肝癌 MM 派姆单抗 依维莫司+MMF CR 存活
    9[14] 63 胆管细胞癌 MM 派姆单抗 泼尼松+MMF NE 存活
    10[14] 57 原发性肝癌 肝癌 纳武单抗 FK506 PD 未知
    11[14] 56 原发性肝癌 肝癌 纳武单抗 MMF+SRL PD 未知
    12[14] 35 原发性肝癌 肝癌 纳武单抗 FK506 PD 未知
    13[14] 64 原发性肝癌 肝癌 纳武单抗 FK506 NE 未知
    14[14] 68 原发性肝癌 肝癌 纳武单抗 SRL PD 死亡
    15[15] 53 原发性肝癌 肝癌 纳武单抗 依维莫司+MMF NE 死亡
    16[16] 20 原发性肝癌 肝癌 纳武单抗 SRL NE 死亡
    17[16] 14 原发性肝癌 肝癌 纳武单抗 FK506 NE 死亡
    18[17] 41 原发性肝癌 肝癌 纳武单抗 FK506 PD 存活
    19[18] 54 肝硬化 NSCLC 纳武单抗 泼尼松+FK506+依维莫司 PD 死亡
    20[19] 75 缺血性心肌病 MM 派姆单抗 FK506 PD 存活
    21[20] 62 - MM 派姆单抗 FK506 PD 死亡
    22[20] 67 缺血性心肌病 MM 派姆单抗 FK506+MMF PD 死亡
    23[12] 73 扩张型心肌病 MM 派姆单抗 FK506 PD 存活
    24[21] 49 扩张型心肌病 cSCC 纳武单抗 泼尼松+FK506+SRL NE 死亡
    25[22] 72 风湿性心脏病 NSCLC 纳武单抗 MMF+环孢素 SD 存活
    26[23] 61 终末期肾病 尿路上皮癌 派姆单抗 MMF+FK506 PR 存活
    27[24] 58 移植肾排斥 MM 派姆单抗 环孢素 PD 死亡
    28[25] 63 肾硬化 cSCC 派姆单抗 SRL+泼尼松 CR 存活
    29[26] 57 - cSCC 派姆单抗 泼尼松 PR 存活
    30[27] 58 终末期肾病 MM 派姆单抗 硫唑嘌呤+依维莫司 PD 死亡
    31[28] 68 多囊肾 MM+cSCC 派姆单抗 泼尼松 NE 存活
    32[12] 60 高血压肾病 MM 派姆单抗 泼尼松 PD 死亡
    33[12] 72 多囊肾 MM 派姆单抗 泼尼松+环孢素+MMF NE 存活
    34[12] 71 糖尿病肾病 MM 派姆单抗 泼尼松+SRL PD 死亡
    35[12] 66 肾细胞癌 MM 派姆单抗 泼尼松+SRL+FK506 PD 死亡
    36[12] 61 IgA肾病 cSCC 派姆单抗 泼尼松+FK506 PR 存活
    37[11] 65 - MM 派姆单抗 泼尼松+MMF+依维莫司 PD 存活
    38[11] 70 - MM 派姆单抗 FK506+泼尼松 PD 存活
    39[11] 75 - MM 派姆单抗 泼尼松 PR 存活
    40[11] 65 - MM 派姆单抗 泼尼松+MMF+FK506 PD 存活
    41[11] 48 - MM 纳武单抗 泼尼松+FK506 PR 存活
    42[12] 79 终末期肾病 MM 纳武单抗 泼尼松+环孢素 PR 存活
    43[22] 69 局灶性节段性肾小球硬化 cSCC 纳武单抗 SRL+泼尼松 PR 存活
    44[24] 60 多囊肾 MM 纳武单抗 泼尼松龙+MMF PD 死亡
    45[29] 64 终末期肾病 肺表皮样癌 纳武单抗 FK506+MMF PD 存活
    46[30] 48 IgA肾病 MM 纳武单抗 泼尼松龙 PR 存活
    47[31] 71 多囊肾 默克尔细胞癌 纳武单抗 泼尼松 CR 存活
    48[32] 63 慢性肾功能衰竭 MM 纳武单抗 泼尼松 PR 存活
    49[33] 72 糖尿病肾病 cSCC 纳武单抗 停用 PR 死亡
    50[34] 77 糖尿病肾病 MM 纳武单抗 泼尼松+FK506 PD 存活
    51[35] 50 多囊肾 cSCC 纳武单抗 SRL+泼尼松 CR 存活
    52[36] 73 - MM 纳武单抗 依维莫司 PD 死亡
    53[37] 74 终末期肾病 NSCLC 纳武单抗 环孢素+泼尼松 NE 存活
    54[38] 70 肾细胞癌 十二指肠腺癌 纳武单抗 泼尼松+SRL SD 存活
    注:①FK506为他克莫司。
    ②SRL为西罗莫司。
    ③MMF为吗替麦考酚酯。
    ④-为资料不齐。
    下载: 导出CSV
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出版历程
  • 收稿日期:  2020-02-17
  • 网络出版日期:  2021-01-19
  • 刊出日期:  2020-05-15

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