内容紹介
Summary
Immunological checkpoint inhibitors have effects on various advanced cancers. Nivolumab was approved for advanced gastric cancer after third-line treatment in 2017. In our hospital, 10 patients were treated with nivolumab from October 2017 to March 2018. Thus, we retrospectively examined the clinical background, treatment outcomes, and adverse events of those patients. The median age was 70 years; male-to-female ratio was 6 :4; recurrence sites were peritoneal dissemination, liver, lymph nodes, brain, ovaries, and bone(8, 2, 2, 1, 1, and 1, respectively); and treatment lines were third, fourth, and fifth(in 6, 3, and 1 patients, respectively). The minimum number of cycles was 1 course, while the maximum was 11 courses. The best tumor response evaluation was SD, and the adverse event was an itching sensation in only one patient. It was suggested that long-term SD could be maintained when the nivolumab treatment was initiated in a patient with good PS. In the future, biomarker analysis is expected to identify effective cases.
要旨
免疫チェックポイント阻害剤が様々な癌種に対して一定の治療効果を示し,今までにない新たな癌治療として注目されている。本邦においては2017年9月に進行・再発胃癌に対しても三次治療以降で保険承認された。今回,2017年10月～2018年3月までに当院で進行・再発胃癌に対するニボルマブ治療を施行した10例を対象とし,臨床背景,治療成績,有害事象を後方視的に検討した。年齢中央値70歳,男女比6:4,再発評価病変は腹膜播種/肝/リンパ節/脳/卵巣/骨=8/2/2/1/1/1,治療ライン 三次/四次/五次=6/3/1,サイクル数1～11,最良画像効果SD,有害事象は全身掻痒感を1例認めた。予後においては,PSが良好な状態からの治療開始がlong SDを期待できることが示唆された。免疫関連有害事象に注意しながら引き続き症例検討を行うとともに,今後は有効症例を絞り込むためのバイオマーカー解析が期待される。
目次
Immunological checkpoint inhibitors have effects on various advanced cancers. Nivolumab was approved for advanced gastric cancer after third-line treatment in 2017. In our hospital, 10 patients were treated with nivolumab from October 2017 to March 2018. Thus, we retrospectively examined the clinical background, treatment outcomes, and adverse events of those patients. The median age was 70 years; male-to-female ratio was 6 :4; recurrence sites were peritoneal dissemination, liver, lymph nodes, brain, ovaries, and bone(8, 2, 2, 1, 1, and 1, respectively); and treatment lines were third, fourth, and fifth(in 6, 3, and 1 patients, respectively). The minimum number of cycles was 1 course, while the maximum was 11 courses. The best tumor response evaluation was SD, and the adverse event was an itching sensation in only one patient. It was suggested that long-term SD could be maintained when the nivolumab treatment was initiated in a patient with good PS. In the future, biomarker analysis is expected to identify effective cases.
要旨
免疫チェックポイント阻害剤が様々な癌種に対して一定の治療効果を示し,今までにない新たな癌治療として注目されている。本邦においては2017年9月に進行・再発胃癌に対しても三次治療以降で保険承認された。今回,2017年10月～2018年3月までに当院で進行・再発胃癌に対するニボルマブ治療を施行した10例を対象とし,臨床背景,治療成績,有害事象を後方視的に検討した。年齢中央値70歳,男女比6:4,再発評価病変は腹膜播種/肝/リンパ節/脳/卵巣/骨=8/2/2/1/1/1,治療ライン 三次/四次/五次=6/3/1,サイクル数1～11,最良画像効果SD,有害事象は全身掻痒感を1例認めた。予後においては,PSが良好な状態からの治療開始がlong SDを期待できることが示唆された。免疫関連有害事象に注意しながら引き続き症例検討を行うとともに,今後は有効症例を絞り込むためのバイオマーカー解析が期待される。