🫁 PD-L1 ≥50% 长期以来支持帕博利珠单抗单药治疗 — 但 PERSEE 询问这些患者中是否有些应在一线接受更多治疗。
@OncoAlert
在 #ESMO26 上，III 期 PERSEE 研究比较了帕博利珠单抗联合铂类化疗与帕博利珠单抗单药，用于 PD-L1 ≥50% 的一线晚期 #NSCLC。
📊 n=321
➡️ 中位 PFS：16.1 对 6.9 个月
HR 0.56 (0.43–0.74), p<0.001
➡️ 中位 OS：50.2 对 29.9 个月
HR 0.77 (0.57–1.05)
➡️ ORR：77.5% 对 50.3%
但权衡巨大：
⚠️ ≥3 级 TRAEs：53.8% 对 19.3%
🎯 为何重要：仅凭 PD-L1 ≥50% 可能不足以决定帕博利珠单抗单药与化疗免疫联合治疗的选择。
对我来说，真正的临床问题现在是：
哪些 PD-L1 高表达患者需要化疗带来的更深、更快的疾病控制 — 哪些可以安全避免额外毒性？
这取决于肿瘤负荷、症状、疾病进展速度、合并症和更好的生物标志物。
出色的工作来自 @decroisette @BenjaminBesseMD @LGreillier @C_Ricordel @FGuisier 及 PERSEE 研究者。
点名 @christine_lovly @GlopesMd @DrSanjayPopat @StephenVLiu @jillfeldman4 @CharuAggarwalMD @peters_solange @BRicciutiMD @VanitaNoronha @JordiRemon
#OncoAlert #ESMO26 #LungCancer #NSCLC #Immunotherapy #PDL1 #PrecisionOncology
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