解读IRC评价标准-.ppt

解解读IRC评价价标准在准在实体瘤中的体瘤中的应用用LOGO天津医科大学天津医科大学肿瘤医院瘤医院张新新伟1Breakthrough of the year 2013 2Why？Antibodies against CTLA-4Antibodies against PD-1 Chimeric antigen receptor therapy,or CAR therapy3CAR therapy4Adoptive cell transfer therapy with CAR-engineered T cells5Result6Immunity and Cancer:immunoediting 789101112PD-L1 in CanceruExpressed on cell surface of 30%solid tumors and selected hematologic malignancies;uInhibits anti-tumor immune responses.PD-1 pathway immunotherapyu2050%response rate in clinical trialsuPD-1 pathway antagonists show broad anti-tumor activity response in:melanoma,RCC,NSCLC,gastric,head and neck,ovarian,colon malignancies.13Patterns of response to ipilimumab observed in advanced melanomaClin Cancer Res 2009;15:7412-7420.PD?14Resected metastatic melanoma tumor nodule of the lung15SD may also be viewed as an indicator of meaningful therapeutic effectLATE BREAKING ABSTRACT:Pooled analysis of long-term survival data from phase II and phase III trials ofipilimumabipilimumab in metastatic or locally advanced,unresectable melanoman 4846 pts,median OS was 9.5 months(95%CI:9.010.0)with a plateau in the OS curve beginning around year 3 for 21%of pts.ORR range from 10-15%16Immune-Related Response Immune-Related Response CriteriaCriteriaTumor Burden=SPDindex lesions+SPDnew,measurable lesions17Shifted from PD by the WHOcriteria to response per irRC18Association of OS with response using WHO criteria or irRC19Patterns of Response in Patients with Pretreated Metastatic MelanomaCancer Investigation,30:712720,201220Early Response to Therapy21Gradual/Delayed Response22Response After Progressive Disease23Initial New Lesions with Superior Response on Retreatment24Mixed Response with Response on Retreatment25Response evaluation criteria in solid tumour26We need new criteria?2728Change in Target Lesions From Baseline After Nivolumab Therapy29NSCLCanti-PD-1;BMS-9365583031Combination of both 3233342014.072014.0735