颞骨鳞状细胞癌的新辅助免疫检查点抑制剂治疗
Neoadjuvant Immune Checkpoint Inhibitor Therapy in Temporal Bone Squamous Cell Carcinoma.
文献信息
| PMID | 42757726 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Kaitlyn E Aragon |
| 作者单位 | Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX. |
| 期刊 | Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology |
| SCI 分区 | Q2 |
| IF | 1.9 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 介绍累及颞骨的鳞状细胞癌的免疫检查点抑制剂免疫治疗（IO）结局，并指导神经耳科决策。
研究设计： 多机构回顾性队列。
地点： 两个三级转诊中心。
患者： 23例（42至86岁）经活检证实累及颞骨的鳞状细胞癌（SCC）患者。
干预： 新辅助IO、评估反应的影像学检查以及手术干预。
主要结局指标： 实体瘤疗效评价标准（RECIST）1.1结局、病理反应、手术降级和总生存期。
结果： 对于最终RECIST 1.1反应，6例（26.1%，95% CI：10%-48%）患者完全缓解（CR），4例（17.4%，95% CI：5%-39%）患者部分缓解（PR），3例（13.0%，95% CI：3%-34%）患者疾病稳定（SD），10例（43.5%，95% CI 23%-66%）患者疾病进展（PD）。对于原发性颞骨肿瘤，36.4%（95% CI：11%-69%）达到病理CR、影像学CR或影像学PR；皮肤SCC肿瘤的缓解率为66.7%（95% CI：35%-90%）。2例（8.7%）可切除疾病患者降级为非手术治疗，2例（8.7%）患者从颞骨外侧切除术（LTBR）降级为乳突切除术。CR、PR或SD患者的3年总生存率为100%，而PD患者为78%（P=0.029，HR 13.2，95% CI：1.3-134）。
结论： 新辅助IO是早期和晚期颞骨SCC的一种选择，约50%的患者表现出缓解，并在选定病例中避免根治性手术和/或辅助放疗；正在进行的新辅助IO 3期试验将增加前瞻性证据。
英文摘要
OBJECTIVE: To present immune checkpoint inhibitor immunotherapy (IO) outcomes for temporal bone-involving squamous cell carcinoma and guide neurotologic decision-making.
STUDY DESIGN: Multi-institutional retrospective cohort.
SETTING: Two tertiary-care referral centers.
PATIENTS: Twenty-three patients (42 to 86 years old) with biopsy-proven temporal bone-involving squamous cell carcinoma (SCC).
INTERVENTIONS: Neoadjuvant IO, imaging to assess response, and surgical interventions.
MAIN OUTCOME MEASURES: Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 outcomes, pathologic response, surgery de-escalation, and overall survival.
RESULTS: For final RECIST 1.1 response, 6 (26.1%, 95% CI: 10%-48%) patients completely responded (CR), 4 (17.4%, 95% CI: 5%-39%) patients partially responded (PR), 3 (13.0%, 95% CI: 3%-34%) patients had stable disease (SD), and disease progressed (PD) in 10 (43.5%, 95% CI 23%-66%) patients. For primary temporal bone tumors, 36.4% (95% CI: 11%-69%) achieved pathologic CR, radiologic CR, or radiologic PR; cutaneous SCC tumors had a 66.7% (95% CI: 35%-90%) response rate. Two (8.7%) patients with resectable disease were de-escalated to nonsurgical management, and 2 (8.7%) patients were de-escalated from lateral temporal bone resection (LTBR) to mastoidectomy. Overall 3-year survival for patients with CR, PR, or SD was 100% versus 78% for PD patients (P=0.029, HR 13.2, 95% CI: 1.3-134).
CONCLUSIONS: Neoadjuvant IO is an option for early-stage and advanced temporal bone SCC, with roughly 50% of patients exhibiting response and avoidance of radical surgery and/or adjuvant radiation in selected cases; ongoing phase 3 trials of neoadjuvant IO will add prospective evidence.