{"id":5685,"date":"2024-08-07T20:54:56","date_gmt":"2024-08-07T12:54:56","guid":{"rendered":"http:\/\/dh.oncolab.cn\/index.php\/2024\/08\/07\/%e8%82%bf%e7%98%a4%e5%85%8d%e7%96%ab%e5%ad%a6-%e7%ac%ac34%e7%ab%a0-%e6%99%9a%e6%9c%9f%e5%8f%8a%e8%be%85%e5%8a%a9%e6%b2%bb%e7%96%97%e4%b8%ad%e9%bb%91%e8%89%b2%e7%b4%a0%e7%98%a4%e7%9a%84%e5%85%8d\/"},"modified":"2024-08-07T20:54:56","modified_gmt":"2024-08-07T12:54:56","slug":"%e8%82%bf%e7%98%a4%e5%85%8d%e7%96%ab%e5%ad%a6-%e7%ac%ac34%e7%ab%a0-%e6%99%9a%e6%9c%9f%e5%8f%8a%e8%be%85%e5%8a%a9%e6%b2%bb%e7%96%97%e4%b8%ad%e9%bb%91%e8%89%b2%e7%b4%a0%e7%98%a4%e7%9a%84%e5%85%8d","status":"publish","type":"post","link":"http:\/\/dh.oncolab.cn\/index.php\/2024\/08\/07\/%e8%82%bf%e7%98%a4%e5%85%8d%e7%96%ab%e5%ad%a6-%e7%ac%ac34%e7%ab%a0-%e6%99%9a%e6%9c%9f%e5%8f%8a%e8%be%85%e5%8a%a9%e6%b2%bb%e7%96%97%e4%b8%ad%e9%bb%91%e8%89%b2%e7%b4%a0%e7%98%a4%e7%9a%84%e5%85%8d\/","title":{"rendered":"\u80bf\u7624\u514d\u75ab\u5b66-\u7b2c34\u7ae0 \u665a\u671f\u53ca\u8f85\u52a9\u6cbb\u7597\u4e2d\u9ed1\u8272\u7d20\u7624\u7684\u514d\u75ab\u6cbb\u7597\u7b56\u7565\uff08\u4e0a\uff09"},"content":{"rendered":"
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\u4e0a\u671f\u5185\u5bb9\uff1a\u80bf\u7624\u514d\u75ab\u5b66-\u7b2c33\u7ae0 \u514d\u75ab\u68c0\u67e5\u70b9\u6291\u5236\u5242\u6cbb\u7597\u764c\u75c7\u7684\u526f\u4f5c\u7528\uff08\u4e0b\uff09<\/span><\/a><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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<\/p>\n<\/section>\n<\/section>\n

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34.1 \u7ec6\u80de\u56e0\u5b50\u5728\u9ed1\u8272\u7d20\u7624\u4e2d\u7684\u4f5c\u7528<\/span><\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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34.1.1 \u03b1-\u5e72\u6270\u7d20 (IFN-\u03b1)<\/p>\n<\/section>\n

\n
\n
\n

\u5e72\u6270\u7d20-\u03b1\u662f\u7f8e\u56fd\u98df\u54c1\u836f\u54c1\u76d1\u7763\u7ba1\u7406\u5c40\uff08FDA\uff09\u6279\u51c6\u7684\u9996\u4e2a\u7528\u4e8e\u6cbb\u7597\u9ed1\u8272\u7d20\u7624\u7684\u7ec6\u80de\u56e0\u5b50\u3002\u867d\u7136\u5bf9\u4e8e\u665a\u671f\u9ed1\u8272\u7d20\u7624\u6765\u8bf4\uff0c\u5e72\u6270\u7d20-\u03b1\u7684\u6548\u679c\u6709\u9650\uff0c\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u663e\u793a\uff0c\u5bf9\u4e8e\u8fd9\u4e00\u9636\u6bb5\u7684\u60a3\u8005\uff0c\u5373\u4f7f\u589e\u52a0\u5316\u7597\u4e5f\u672a\u80fd\u663e\u8457\u63d0\u9ad8\u751f\u5b58\u7387\u30021996\u5e74\uff0c\u5e72\u6270\u7d20-\u03b1\u88ab\u6279\u51c6\u4f5c\u4e3aIIIB-III\u671f\u9ad8\u98ce\u9669\u9ed1\u8272\u7d20\u7624\u672f\u540e\u7684\u8f85\u52a9\u6cbb\u7597\u3002\u5728\u540e\u7eed\u7684\u8f85\u52a9\u514d\u75ab\u6cbb\u7597\u7ae0\u8282\u4e2d\uff0c\u5c06\u8fdb\u4e00\u6b65\u8ba8\u8bba\u5e72\u6270\u7d20-\u03b1\u7684\u4f7f\u7528\u7ec6\u8282\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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34.1.2 \u767d\u4ecb\u7d20-2 (IL-2)<\/p>\n<\/section>\n

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Rosenberg\u53ca\u5176\u56e2\u961f\u5728\u767d\u7ec6\u80de\u4ecb\u7d20-2\uff08IL-2\uff09\u7684\u5e94\u7528\u7814\u7a76\u4e2d\u53d6\u5f97\u4e86\u5f00\u521b\u6027\u6210\u679c\u3002\u4ed6\u4eec\u9996\u5148\u63a2\u7d22\u4e86IL-2\u5355\u72ec\u4f7f\u7528\uff0c\u968f\u540e\u4e0e\u6dcb\u5df4\u56e0\u5b50\u6fc0\u6d3b\u7684\u6740\u4f24\u7ec6\u80de\uff08LAK\uff09\u53ca\u80bf\u7624\u6d78\u6da6\u6dcb\u5df4\u7ec6\u80de\uff08TIL\uff09\u7684\u7ec4\u5408\u4f7f\u7528\u3002\u8fd9\u4e9b\u7814\u7a76\u6700\u7ec8\u8bc1\u5b9e\u4e86IL-2\u5728\u6cbb\u7597\u665a\u671f\u9ed1\u8272\u7d20\u7624\u4e2d\u7684\u6709\u6548\u6027\uff0c1998\u5e74\uff0cIL-2\u56e0\u6b64\u88ab\u6279\u51c6\u4e3a\u6cbb\u7597\u665a\u671f\u9ed1\u8272\u7d20\u7624\u7684\u9996\u4e2a\u514d\u75ab\u7597\u6cd5\u3002Rosenberg\u53ca\u5176\u56e2\u961f\u8fd8\u5f00\u5c55\u4e86\u4e00\u7cfb\u5217\u91c7\u7528\u8fc7\u7ee7\u7ec6\u80de\u7597\u6cd5\uff08ACT\uff09\u7684\u764c\u75c7\u6cbb\u7597\u9879\u76ee\uff0c\u5c24\u5176\u662f\u9488\u5bf9\u9ed1\u8272\u7d20\u7624\uff0c\u591a\u5e74\u7684\u7814\u7a76\u5728\u7406\u8bba\u548c\u5b9e\u8df5\u4e0a\u53d6\u5f97\u4e86\u663e\u8457\u8fdb\u5c55\u3002\u5728\u7279\u5b9a\u60a3\u8005\u7fa4\u4f53\u4e2d\uff0c\u7ed3\u5408\u5316\u7597\u6e05\u9664\u6dcb\u5df4\u7ec6\u80de\uff0c\u6709\u65f6\u914d\u5408\u5168\u8eab\u7167\u5c04\uff0c\u968f\u540e\u8fdb\u884c\u80bf\u7624\u6765\u6e90\u7684T\u7ec6\u80de\u514b\u9686\u53caIL-2\u6cbb\u7597\uff0c\u53ef\u4ee5\u8fbe\u523050-70%\u7684\u7f13\u89e3\u7387\uff0c\u5176\u4e2d\u5b8c\u5168\u7f13\u89e3\uff08CR\uff09\u7387\u4e3a10-20%\u3002\u76ee\u524d\uff0c\u4f7f\u7528\u57fa\u56e0\u5de5\u7a0b\u6539\u9020\u7684\u81ea\u4f53\u7ec6\u80de\u8868\u8fbeT\u7ec6\u80de\u53d7\u4f53\u662f\u4e00\u4e2a\u6709\u5e0c\u671b\u7684\u65b9\u6cd5\uff0c\u4f46\u8fd9\u4e9b\u6280\u672f\u4ecd\u4e3b\u8981\u9650\u4e8e\u5c11\u6570\u4e13\u4e1a\u4e2d\u5fc3\u8fdb\u884c\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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34.1.3 \u80bf\u7624\u574f\u6b7b\u56e0\u5b50-\u03b1 (TNF-\u03b1)<\/p>\n<\/section>\n

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\u7531\u4e8e\u5242\u91cf\u76f8\u5173\u7684\u6bd2\u6027\uff0c\u5c24\u5176\u662f\u4f4e\u8840\u538b\u7684\u95ee\u9898\uff0c\u5168\u8eab\u6027\u5e94\u7528\u80bf\u7624\u574f\u6b7b\u56e0\u5b50-\u03b1\uff08TNF-\u03b1\uff09\u7684\u6cbb\u7597\u53d1\u5c55\u53d7\u5230\u9650\u5236\uff0c\u4f4e\u5242\u91cf\u65f6\u6548\u679c\u4e0d\u4f73\u3002\u7136\u800c\uff0c\u5728\u5b64\u7acb\u80a2\u4f53\u704c\u6ce8\uff08ILP\uff09\u6280\u672f\u4e2d\uff0c\u53ef\u4ee5\u5728\u5c40\u90e8\u8fbe\u5230\u6709\u6548\u6d53\u5ea6\uff0c\u663e\u793a\u51fa\u8f83\u597d\u7684\u6cbb\u7597\u6548\u679c\u3002\u5728\u6b64\u6280\u672f\u5e94\u7528\u4e0b\uff0c\u4e0emelphalan\uff08\u4e00\u79cd\u5316\u7597\u836f\u7269\uff09\u8054\u7528\uff0c\u53ef\u5728\u591a\u53d1\u6027\u8f6c\u79fb\u6027\u9ed1\u8272\u7d20\u7624\u60a3\u8005\u4e2d\u4ea7\u751f\u663e\u8457\u7684\u534f\u540c\u6548\u5e94\u30021998\u5e74\uff0c\u9488\u5bf9\u5371\u53ca\u80a2\u4f53\u7684\u8f6f\u7ec4\u7ec7\u8089\u7624\uff0c\u80bf\u7624\u574f\u6b7b\u56e0\u5b50-\u03b1\u83b7\u5f97\u6b27\u6d32\u836f\u54c1\u7ba1\u7406\u5c40\uff08EMA\uff09\u7684\u6279\u51c6\uff0c\u4e3b\u8981\u7528\u4e8e\u6cbb\u7597\u8f6f\u7ec4\u7ec7\u8089\u7624\u548c\u9ed1\u8272\u7d20\u7624\u7684\u591a\u53d1\u6027\u8f6c\u79fb\u3002\u76ee\u524d\u5168\u7403\u7ea6\u670950\u4e2a\u4e13\u4e1a\u4e2d\u5fc3\u8fd0\u884c\u80a2\u4f53\u4fdd\u7559\u6cbb\u7597\u9879\u76ee\uff0c\u53d6\u5f97\u4e86\u826f\u597d\u7684\u957f\u671f\u6210\u6548\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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34.1.4 \u4f7f\u7528\u514d\u75ab\u68c0\u67e5\u70b9\u6291\u5236\u5242\u6253\u7834\u8010\u53d7\u6027<\/p>\n<\/section>\n

\n
\n
\n

\u76ee\u524d\uff0c\u9ed1\u8272\u7d20\u7624\u6cbb\u7597\u7684\u91cd\u5927\u8fdb\u5c55\u4e3b\u8981\u96c6\u4e2d\u5728\u514d\u75ab\u6cbb\u7597\u548c\u7a81\u53d8\u9a71\u52a8\u7684\u836f\u7269\u5f00\u53d1\u4e0a\u3002\u514b\u670d\u80bf\u7624\u8010\u836f\u6027\u662f\u6cbb\u7597\u9ed1\u8272\u7d20\u7624\u7684\u4e00\u5927\u7a81\u7834\uff0c\u6211\u4eec\u5df2\u8fdb\u5165\u4e00\u4e2a\u65b0\u65f6\u4ee3\uff0c\u7531\u4e8e\u9996\u6279\u514d\u75ab\u68c0\u67e5\u70b9\u6291\u5236\u5242\u2014\u2014\u6297CTLA-4\uff08\u7ec6\u80de\u6bd2\u6027T\u6dcb\u5df4\u7ec6\u80de\u6297\u539f-4\uff09\u548c\u6297PD-1\/\u6297PD-L1\uff08\u7a0b\u5e8f\u6027\u6b7b\u4ea1-1\u53ca\u5176\u914d\u4f53\uff09\u7684\u4f7f\u7528\uff0c\u8fd9\u4e9b\u6cbb\u7597\u65b9\u5f0f\u7684\u6548\u679c\u524d\u6240\u672a\u6709\u3002\u77ed\u77ed\u4e94\u5e74\u5185\uff0c\u665a\u671f\u9ed1\u8272\u7d20\u7624\u4ece\u4e00\u79cd\u51e0\u4e4e\u65e0\u6cd5\u6cbb\u6108\u7684\u75be\u75c5\u8f6c\u53d8\u4e3a\u6709\u671b\u6cbb\u6108\u7684\u75be\u75c5\uff0c\u6211\u4eec\u6b63\u5728\u5f00\u59cb\u8ba4\u8bc6\u5230\u8fd9\u4e9b\u6cbb\u7597\u5728\u6574\u4e2a\u5b9e\u4f53\u7624\u9886\u57df\u7684\u6f5c\u5728\u5f71\u54cd(Table 34.1<\/span>)<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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<\/section>\n<\/section>\n
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<\/p>\n<\/section>\n<\/section>\n

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Table 34.1<\/span> \u5e72\u6270\u7d20\u3001\u4f0a\u5339\u5355\u6297\u3001\u7eb3\u6b66\u5355\u6297\u548c\u6d3e\u59c6\u5355\u6297\u7684\u5173\u952eIII\u671f\u514d\u75ab\u6cbb\u7597\u8bd5\u9a8c<\/span><\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
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<\/p>\n<\/section>\n<\/section>\n

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34.2 \u6297CTLA-4\u6cbb\u7597<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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34.2.1 \u665a\u671f\u9ed1\u8272\u7d20\u7624\u60a3\u8005\u7684\u6cbb\u7597\u6548\u679c<\/p>\n<\/section>\n

\n
\n
\n

\u963b\u65ad\u7ec6\u80de\u6bd2\u6027T\u6dcb\u5df4\u7ec6\u80de\u6297\u539f-4 (CTLA-4)\u7684\u5355\u514b\u9686\u6297\u4f53\u53ef\u4ee5\u6253\u7834\u514d\u75ab\u8010\u53d7\uff0c\u4fc3\u8fdb\u80bf\u7624\u7f29\u5c0f\u3002\u5168\u4eba\u6e90\u5316\u7684\u5355\u514b\u9686\u6297CTLA-4\u6297\u4f53\uff0c\u4f0a\u5339\u5355\u6297\uff08ipilimumab\uff09\uff0c\u4e8e2011\u5e74\u5728\u7f8e\u56fd\u88ab\u6279\u51c6\u7528\u4e8e\u665a\u671f\u9ed1\u8272\u7d20\u7624\u60a3\u8005\u7684\u4e00\u7ebf\u548c\u4e8c\u7ebf\u6cbb\u7597\u3002\u6839\u636e\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\uff08RCT\uff09\u7684\u7ed3\u679c\uff0c\u4f0a\u5339\u5355\u6297\u5728\u6b27\u6d32\u88ab\u6279\u51c6\u7528\u4e8e\u4e8c\u7ebf\u6cbb\u7597\uff0c\u5242\u91cf\u4e3a3 mg\/kg\uff0c\u663e\u793a\u4e0e\u5355\u72ec\u63a5\u79cd\u75ab\u82d7\u76f8\u6bd4\uff0c\u4f0a\u5339\u5355\u6297\u5355\u72ec\u4f7f\u7528\u6216\u4e0e\u80bd\u75ab\u82d7\u8054\u5408\u4f7f\u7528\u80fd\u663e\u8457\u63d0\u9ad8\u751f\u5b58\u6548\u76ca\u7ea633%\u3002\u5728\u4e00\u7ebf\u6cbb\u7597\u4e2d\uff0c10 mg\/kg\u5242\u91cf\u7684\u4f0a\u5339\u5355\u6297\u8054\u5408\u8fbe\u5361\u5df4\u55ea\u867d\u7136\u5728\u7edf\u8ba1\u4e0a\u663e\u8457\uff0c\u4f46\u63d0\u4f9b\u7684\u6cbb\u7597\u6548\u679c\u6709\u9650\uff0c\u56e0\u6b64\u4e0d\u63a8\u8350\u8054\u5408\u7528\u836f\u3002\u957f\u671f\u968f\u8bbf\u6570\u636e\u8bc1\u5b9e\u4e86\u8fd9\u4e00\u70b9\uff0c\u8868\u660e\u8fbe\u5361\u5df4\u55ea\u548c\u4f0a\u5339\u5355\u6297\u8054\u5408\u6cbb\u7597\u76845\u5e74\u751f\u5b58\u7387\u7ea6\u4e3a20%\uff0c\u4e0e\u5355\u72ec\u4f7f\u7528\u4f0a\u5339\u5355\u6297\u7684\u60c5\u51b5\u76f8\u4f3c\u3002\u6b64\u5916\uff0c\u53e6\u4e00\u79cd\u5355\u514b\u9686\u6297\u4f53\u897f\u6728\u5355\u6297\uff08tremelimumab\uff09\u5355\u836f\u6cbb\u7597\u7684\u957f\u671f\u751f\u5b58\u7387\u540c\u6837\u4e3a20%\uff0c\u4e14\u5176\u5bf9\u8111\u8f6c\u79fb\u60a3\u8005\u7684\u7597\u6548\u4e5f\u5df2\u5f97\u5230\u8bc1\u5b9e\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n

\u56e0\u4e3a\u6cbb\u7597\u53ef\u80fd\u5bfc\u81f4\u6700\u521d\u7684\u80bf\u7624\u8fdb\u5c55\u6216\u65b0\u75c5\u53d8\u51fa\u73b0\uff0c\u5df2\u7ecf\u5236\u5b9a\u4e86\u514d\u75ab\u76f8\u5173\u53cd\u5e94\u6807\u51c6\uff08irRC\uff09\u4ee5\u907f\u514d\u8fc7\u65e9\u4e2d\u65ad\u6cbb\u7597\u3002\u57283 mg\/kg\u5242\u91cf\u4e0b\uff0c40%\u7684\u60a3\u8005\u4f1a\u51fa\u73b0\u4e0d\u826f\u4e8b\u4ef6\uff0c\u5927\u591a\u6570\u4e0e\u514d\u75ab\u76f8\u5173\uff08irAE\uff09\uff0c\u4f8b\u5982\u76ae\u75b9\u3001\u7ed3\u80a0\u708e\u3001\u809d\u708e\u548c\u5782\u4f53\u708e\u3002\u5927\u7ea620%\u7684\u60a3\u8005\u4f1a\u51fa\u73b03-4\u7ea7\u4e0d\u826f\u4e8b\u4ef6\uff0c\u6781\u5c11\u6570\u60c5\u51b5\u53ef\u80fd\u81f4\u547d\u3002\u5185\u5206\u6ccc\u8870\u7aed\u901a\u5e38\u9700\u8981\u6c38\u4e45\u6027\u6fc0\u7d20\u66ff\u4ee3\uff0c\u4f46\u8fd9\u4e9b\u4e8b\u4ef6\u901a\u5e38\u4f1a\u5728\u7c7b\u56fa\u9187\u6cbb\u7597\u540e\u81ea\u884c\u7f13\u89e3\u6216\u6d88\u9000\u3002\u5bf9\u4e8e\u4e25\u91cd\u7684irAE\uff0c\u901a\u5e38\u4f7f\u7528\u5927\u5242\u91cf\u7c7b\u56fa\u9187\u6cbb\u7597\uff0c\u6709\u65f6\u8fd8\u9700\u4f7f\u7528\u5176\u4ed6\u514d\u75ab\u6291\u5236\u5242\uff0c\u5982\u6297TNF-\u03b1\u6297\u4f53\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n

\u5173\u4e8e\u4f0a\u5339\u5355\u6297\u7684\u5242\u91cf\u6709\u6548\u6027\uff0c\u4e00\u9879\u6bd4\u8f830.3\u30013\u548c10 mg\/kg\u7684\u968f\u673aII\u671f\u8bd5\u9a8c\u663e\u793a\uff0c10 mg\/kg\u5242\u91cf\u66f4\u4e3a\u6709\u6548\uff0c\u4f46\u4f34\u968f\u66f4\u9ad8\u7684\u6bd2\u6027\u30022016\u5e74\u7684\u968f\u673aIII\u671f\u8bd5\u9a8c\u7ed3\u679c\u660e\u786e\u6307\u51fa\uff0c\u5bf9\u4e8e\u665a\u671f\u9ed1\u8272\u7d20\u7624\u60a3\u8005\uff0c10 mg\/kg\u7684\u5242\u91cf\u8f833 mg\/kg\u66f4\u4e3a\u6709\u6548\uff0c\u603b\u4f53\u751f\u5b58\u6548\u679c\u663e\u8457\uff08HR 0.84; P < 0.04\uff09\uff0c3\u5e74\u751f\u5b58\u7387\u7684\u7edd\u5bf9\u5dee\u5f02\u4e3a8%\uff0831%\u5bf923%\uff09\u3002\u8fd9\u4e9b\u7597\u6548\u7684\u63d0\u9ad8\u662f\u4ee5\u589e\u52a0\u7684\u6bd2\u6027\u4e3a\u4ee3\u4ef7\u7684\uff083-5\u7ea7\u4e8b\u4ef6\u7387\u5206\u522b\u4e3a34%\u4e0e19%\uff0c30%\u4e0e14%\uff09\u3002\u76ee\u524d\u8fd8\u672a\u786e\u5b9a4\u6b213\u5468\u95f4\u9694\u7684\u7ed9\u836f\uff08\u8bf1\u5bfc\u671f\uff09\u4e0e\u4e4b\u540e\u7684\u7ef4\u6301\u6cbb\u7597\u7684\u5177\u4f53\u4ef7\u503c\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

34.2.2 \u751f\u7269\u6807\u5fd7\u7269<\/p>\n<\/section>\n

\n
\n
\n

\u76ee\u524d\u5c1a\u672a\u786e\u7acb\u5bf9\u4f0a\u5339\u5355\u6297\u6cbb\u7597\u53cd\u5e94\u7684\u53ef\u9760\u751f\u7269\u6807\u5fd7\u7269\u3002\u4e0e\u66f4\u9ad8\u5e94\u7b54\u7387\u76f8\u5173\u7684\u56e0\u7d20\u5305\u62ec\u514d\u75ab\u76f8\u5173\u7684\u4e0d\u826f\u4e8b\u4ef6\u3001\u6dcb\u5df4\u7ec6\u80de\u8ba1\u6570\u589e\u52a0\u3001\u55dc\u9178\u6027\u7c92\u7ec6\u80de\u8ba1\u6570\u589e\u52a0\u3001NY-ESO-1\u6297\u539f\u7684\u8868\u8fbe\uff0c\u4ee5\u53ca\u4f53\u5916\u5bf9\u8c03\u8282\u6027T\u7ec6\u80de\uff08Treg\uff09\u529f\u80fd\u7684\u6291\u5236\u3002\u6b64\u5916\uff0c\u8fd1\u5e74\u6765\u7684\u7814\u7a76\u8868\u660e\uff0c\u8840\u6e05\u4e2d\u53ef\u6eb6\u6027CD25\u7684\u9ad8\u6c34\u5e73\uff0c\u5c24\u5176\u662f\u5f53\u4e0e\u4e73\u9178\u8131\u6c22\u9176\uff08LDH\uff09\u7684\u9ad8\u6c34\u5e73\u540c\u65f6\u51fa\u73b0\u65f6\uff0c\u53ef\u80fd\u9884\u793a\u7740\u8f83\u5dee\u7684\u9884\u540e\u3002\u603b\u4f53\u800c\u8a00\uff0c\u76ee\u524d\u6211\u4eec\u4e3b\u8981\u62e5\u6709\u7684\u662f\u9884\u540e\u751f\u7269\u6807\u5fd7\u7269\uff0c\u800c\u7f3a\u4e4f\u4e34\u5e8a\u4e0a\u6709\u91cd\u8981\u9884\u6d4b\u4ef7\u503c\u7684\u751f\u7269\u6807\u5fd7\u7269\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

34.2.3 \u9ed1\u8272\u7d20\u7624\u7684\u8f85\u52a9\u6cbb\u7597\u53ca\u4f0a\u5339\u5355\u6297\u7684\u8fd1\u671f\u6279\u51c6<\/p>\n<\/section>\n

\n
\n
\n

\u76ee\u524d\uff0c\u4e3aIII\u671f\u9ed1\u8272\u7d20\u7624\u60a3\u8005\u6279\u51c6\u7684\u8f85\u52a9\u6cbb\u7597\u836f\u7269\u5305\u62ec\u91cd\u7ec4\u5e72\u6270\u7d20\u03b1-2b\uff08\u5728\u7f8e\u56fd\u548c\u6b27\u76df\uff09\uff0c\u6b64\u836f\u7269\u7684\u6279\u51c6\u57fa\u4e8eECOG 1684\u8bd5\u9a8c\u7ed3\u679c\uff1b\u4ee5\u53ca\u805a\u4e59\u4e8c\u9187\u5316\u5e72\u6270\u7d20\u03b1-2b\uff08\u5728\u7f8e\u56fd\uff09\uff0c\u5176\u6279\u51c6\u5219\u57fa\u4e8eEORTC 18991\u8bd5\u9a8c\u3002\u5bf9\u8f85\u52a9\u5e72\u6270\u7d20\u6cbb\u7597\u7684\u5206\u6790\u663e\u793a\uff0c\u6cbb\u7597\u7684\u5242\u91cf\u548c\u6301\u7eed\u65f6\u95f4\u4f3c\u4e4e\u5bf9\u6cbb\u7597\u6548\u679c\u6ca1\u6709\u663e\u8457\u5f71\u54cd\uff0c\u4e14\u53ea\u89c2\u5bdf\u5230\u5bf9\u751f\u5b58\u7387\u7ea63%\u7684\u6539\u5584\u3002\u56e0\u6b64\uff0c\u5e72\u6270\u7d20\u7684\u8f85\u52a9\u6cbb\u7597\u5e76\u672a\u88ab\u5e7f\u6cdb\u63a5\u53d7\u6216\u6210\u4e3a\u6cbb\u7597\u6807\u51c6\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

34.2.3.1 \u4f0a\u5339\u5355\u6297\u5355\u6297\u5ef6\u957f\u65e0\u590d\u53d1\u671f\u548c\u603b\u751f\u5b58\u671f<\/p>\n<\/section>\n

\n
\n
\n

\u5728EORTC 18071\u8bd5\u9a8c\u4e2d\uff0c951\u4f8bIII\u671f\u9ed1\u8272\u7d20\u7624\u60a3\u8005\uff0c\u5728\u63a5\u53d7\u5b8c\u5168\u533a\u57df\u6dcb\u5df4\u7ed3\u5207\u9664\u672f\u540e\uff0c\u88ab\u968f\u673a\u5206\u914d\u63a5\u53d7\u4f0a\u5339\u5355\u629710 mg\/kg\u6216\u5b89\u6170\u5242\uff0c\u6bcf3\u5468\u4e00\u6b21\u9759\u8109\u8f93\u6ce8\u51714\u6b21\uff08\u8bf1\u5bfc\u671f\uff09\uff0c\u968f\u540e\u6bcf3\u4e2a\u6708\u4e00\u6b21\uff0c\u6301\u7eed3\u5e74\uff08\u7ef4\u6301\u671f\uff09\uff0c\u6216\u76f4\u81f3\u75be\u75c5\u590d\u53d1\u6216\u51fa\u73b0\u4e0d\u53ef\u63a5\u53d7\u7684\u6bd2\u6027\u4e3a\u6b62\u3002\u7814\u7a76\u7684\u4e3b\u8981\u7ec8\u70b9\u662f\u65e0\u590d\u53d1\u751f\u5b58\u671f\uff08RFS\uff09\u30022015\u5e74\u7684\u7ed3\u679c\u663e\u793a\uff0c\u4f0a\u5339\u5355\u6297\u663e\u8457\u6539\u5584\u4e86RFS\uff08\u98ce\u9669\u6bd40.75, p=0.0013\uff09\uff0c\u5e76\u56e0\u6b64\u83b7\u5f97\u4e86FDA\u7684\u6279\u51c6\u3002\u52302016\u5e74\uff0c\u4e2d\u4f4d\u968f\u8bbf\u65f6\u95f4\u8fbe\u52305.3\u5e74\uff0c\u6570\u636e\u663e\u793a\uff0c\u4e0e\u5b89\u6170\u5242\u76f8\u6bd4\uff0c\u4f0a\u5339\u5355\u6297\u663e\u8457\u63d0\u9ad8\u4e86\u603b\u751f\u5b58\u7387\uff08OS\uff09\uff08\u6b7b\u4ea1\u98ce\u9669\u6bd40.72; 95.1% CI, 0.58-0.88; p=0.001\uff09\u548c\u65e0\u8fdc\u5904\u8f6c\u79fb\u751f\u5b58\u671f\uff08DMFS\uff09\uff08\u6b7b\u4ea1\u6216\u8fdc\u5904\u8f6c\u79fb\u7684\u98ce\u9669\u6bd40.76; 95.8% CI, 0.64-0.92; p=0.002\uff09\u3002\u4f0a\u5339\u5355\u6297\u7ec4\u76845\u5e74OS\u7387\u4e3a65.4%\uff0c\u5b89\u6170\u5242\u7ec4\u4e3a54.4%\uff1b\u4f0a\u5339\u5355\u6297\u7ec4\u76845\u5e74DMFS\u7387\u4e3a48.3%\uff0c\u5b89\u6170\u5242\u7ec4\u4e3a38.9%\u3002\u5148\u524d\u89c2\u5bdf\u5230\u7684\u65e0\u590d\u53d1\u751f\u5b58\u83b7\u76ca\u5f97\u5230\u4e86\u7ef4\u6301\uff08\u6b7b\u4ea1\u6216\u590d\u53d1\u7684\u98ce\u9669\u6bd40.76; 95% CI, 0.64-0.89; p<0.001\uff09\u3002\u6cbb\u7597\u6548\u679c\u5728\u5404\u4e9a\u7ec4\u4e2d\u603b\u4f53\u4e00\u81f4\uff0cIIIC\u671f\u60a3\u8005\u4f3c\u4e4e\u6bd4IIIB\u671f\u548cIIIA\u671f\u60a3\u8005\u83b7\u76ca\u66f4\u591a\uff0c\u8fd9\u662f\u552f\u4e00\u4e00\u4e2a\u6ca1\u6709\u660e\u663e\u83b7\u76ca\u7684\u4e9a\u7ec4\uff08HR 0.98\uff09\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

34.2.4 \u6e83\u75a1\u6027\u9ed1\u8272\u7d20\u7624\u60a3\u8005\u83b7\u76ca\u6700\u663e\u8457<\/p>\n<\/section>\n

\n
\n
\n

\u4e8b\u540e\u5206\u6790\u663e\u793a\uff0c\u5728\u524d\u54e8\u6dcb\u5df4\u7ed3\u9633\u6027\u548c\u53ef\u89e6\u53ca\u6dcb\u5df4\u7ed3\u9633\u6027\u7684\u9ed1\u8272\u7d20\u7624\u60a3\u8005\u4e2d\uff0c\u4f0a\u5339\u5355\u6297\u7684\u6cbb\u7597\u6548\u679c\u90fd\u6709\u663e\u8457\u63d0\u5347\u3002\u8fd9\u4e0eEORTC\u7684\u8f85\u52a9\u8bd5\u9a8c18952\u548c18991\u4e2d\uff0c\u4f7f\u7528\u5e72\u6270\u7d20\uff08IFN\uff09\u548c\u805a\u4e59\u4e8c\u9187\u5316IFN\u6cbb\u7597\u7684\u524d\u54e8\u9633\u6027\u75be\u75c5\u60a3\u8005\u83b7\u5f97\u66f4\u5927\u76ca\u5904\u7684\u7ed3\u679c\u4e00\u81f4\u3002\u540c\u6837\uff0c\u6e83\u75a1\u6027\u539f\u53d1\u80bf\u7624\u7684\u60a3\u8005\u4ece\u6cbb\u7597\u4e2d\u83b7\u5f97\u7684\u76ca\u5904\u6700\u5927\uff0c\u8fd9\u7a81\u663e\u4e86\u6e83\u75a1\u6027\u9ed1\u8272\u7d20\u7624\u4f5c\u4e3a\u4e00\u4e2a\u72ec\u7acb\u7684\u751f\u7269\u5b9e\u4f53\u7684\u7279\u6027\u3002\u7136\u800c\uff0c\u4e0eEORTC 18952\u548c18991\u8bd5\u9a8c\u4e2d\u5e72\u6270\u7d20\u6cbb\u7597\u7684\u7ed3\u679c\u76f8\u53cd\uff0c\u975e\u6e83\u75a1\u6027\u9ed1\u8272\u7d20\u7624\u60a3\u8005\u5728\u63a5\u53d7\u4f0a\u5339\u5355\u6297\u7684\u8f85\u52a9\u6cbb\u7597\u65f6\u4e5f\u663e\u793a\u51fa\u4e86\u6cbb\u7597\u76ca\u5904\u3002\u8fd9\u4e0e\u5e72\u6270\u7d20\u6cbb\u7597\u672a\u663e\u793a\u4efb\u4f55\u76ca\u5904\u5f62\u6210\u9c9c\u660e\u5bf9\u6bd4\uff0c\u6700\u8fd1\u5bf9\u6240\u6709\u5e72\u6270\u7d20\u8f85\u52a9\u6cbb\u7597\u4e0e\u89c2\u5bdf\u8bd5\u9a8c\u7684\u4e2a\u4f53\u60a3\u8005\u6570\u636e\uff08IPD\uff09\u5206\u6790\u4e5f\u8bc1\u5b9e\u4e86\u8fd9\u4e00\u70b9\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

34.2.4.1 \u6bd2\u6027\u548c\u751f\u6d3b\u8d28\u91cf<\/p>\n<\/section>\n

\n
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\n

\u5728EORTC 18071\u4f0a\u5339\u5355\u6297\u8f85\u52a9\u8bd5\u9a8c\u4e2d\uff0c\u5c3d\u7ba1\u53d1\u751f\u4e86\u8f83\u9ad8\u6bd4\u4f8b\u7684\u4e25\u91cd\u4e0d\u826f\u4e8b\u4ef6\uff0c\u5168\u7403\u5065\u5eb7\u751f\u6d3b\u8d28\u91cf\u8bc4\u5206\u5728\u6cbb\u7597\u7ec4\u95f4\u5e76\u65e0\u663e\u8457\u5dee\u5f02\u3002\u8fd9\u4e00\u70b9\u6709\u4e9b\u51fa\u4e4e\u610f\u6599\uff0c\u56e0\u4e3a\u53ea\u670942%\u7684\u60a3\u8005\u80fd\u63a5\u53d7\u8d85\u8fc74\u5242\u7684\u4f0a\u5339\u5355\u6297\uff0c\u800c\u53ea\u670928.9%\u7684\u60a3\u8005\u63a5\u53d7\u4e86\u8d85\u8fc71\u5e74\u7684\u6cbb\u7597\u3002\u5728\u63a5\u53d7\u4f0a\u5339\u5355\u6297\u7684\u60a3\u8005\u4e2d\uff0c\u670941.6%\u53d1\u751f\u4e863-4\u7ea7\u514d\u75ab\u76f8\u5173\u4e0d\u826f\u4e8b\u4ef6\uff08irAE\uff09\uff0c\u800c\u5728\u5b89\u6170\u5242\u7ec4\u4e2d\u8fd9\u4e00\u6bd4\u4f8b\u4e3a2.7%\u3002\u5176\u4e2d\u6700\u5e38\u89c1\u7684\u4e25\u91cdirAE\u5305\u62ec\u8179\u6cfb\/\u7ed3\u80a0\u708e\uff0817.2%\uff09\u3001\u809d\u708e\uff0815.2%\uff09\u3001\u5185\u5206\u6ccc\u75be\u75c5\uff087.8%\uff09\u3001\u5782\u4f53\u708e\uff084.4%\uff09\u548c\u795e\u7ecf\u7cfb\u7edf\u4e8b\u4ef6\uff081.1%\uff09\u3002\u6b64\u5916\uff0c\u67095\u4f8b\u60a3\u8005\u56e0\u836f\u7269\u76f8\u5173\u539f\u56e0\u6b7b\u4ea1\uff0c\u5305\u62ec3\u4f8b\u7ed3\u80a0\u708e\u30011\u4f8b\u5fc3\u808c\u708e\u548c1\u4f8b\u56e0\u683c\u6797-\u5df4\u5229\u7efc\u5408\u75c7\u5bfc\u81f4\u7684\u591a\u5668\u5b98\u8870\u7aed\u3002\u5927\u591a\u6570\u4e25\u91cdirAE\u53d1\u751f\u5728\u6cbb\u7597\u7684\u8bf1\u5bfc\u671f\u3002\u5728\u505c\u7528\u4f0a\u5339\u5355\u6297\u5e76\u5f00\u59cb\u76ae\u8d28\u7c7b\u56fa\u9187\u6cbb\u7597\u540e\uff0c\u9664\u5185\u5206\u6ccc\u6cbb\u7597\u5916\uff08\u4e2d\u4f4d\u7f13\u89e3\u65f6\u95f4\u4e3a31\u5468\uff09\uff0c\u5176\u4ed6\u4e0d\u826f\u4e8b\u4ef6\u7684\u4e2d\u4f4d\u7f13\u89e3\u65f6\u95f4\u4e3a6\u5468\u3002<\/p>\n

\u5c3d\u7ba1\u4f0a\u5339\u5355\u6297\u5728\u65e0\u590d\u53d1\u751f\u5b58\u671f\uff08RFS\uff09\u3001\u65e0\u8fdc\u5904\u8f6c\u79fb\u751f\u5b58\u671f\uff08DMFS\uff09\u548c\u603b\u751f\u5b58\u671f\uff08OS\uff09\u65b9\u9762\u63d0\u4f9b\u4e86\u6301\u7eed\u6539\u5584\uff0c\u4f46\u5b83\u4e5f\u5e26\u6765\u4e86\u4e0d\u5c0f\u7684\u514d\u75ab\u76f8\u5173\u4e0d\u826f\u4e8b\u4ef6\uff08irAE\uff09\uff0c\u8fd9\u8981\u6c42\u533b\u7597\u56e2\u961f\u5177\u5907\u4e13\u4e1a\u77e5\u8bc6\u548c\u7ecf\u9a8c\uff0c\u4ee5\u4fbf\u80fd\u591f\u53ca\u65f6\u8bc6\u522b\u548c\u6309\u7167\u5df2\u5efa\u7acb\u7684\u6cbb\u7597\u65b9\u6848\u8fdb\u884c\u5904\u7406\u3002\u56e0\u6b64\uff0c\u8fd9\u79cd\u6cbb\u7597\u5e94\u7531\u7ecf\u9a8c\u4e30\u5bcc\u7684\u4e2d\u5fc3\u6267\u884c\u3002<\/p>\n

\u6b64\u5916\uff0c\u8bd5\u9a8c\u7ed3\u679c\u5e76\u672a\u663e\u793a\u5728\u5b8c\u6210\u8bf1\u5bfc\u671f\u56db\u6b21\u7ed9\u836f\u540e\u9700\u8981\u8fdb\u884c\u7ef4\u6301\u6cbb\u7597\u3002\u5bf9\u4e8e\u590d\u53d1\u98ce\u9669\u8f83\u4f4e\u7684IIIA\u671f\u60a3\u8005\uff0c\u4f0a\u5339\u5355\u6297\u672a\u663e\u793a\u51fa\u663e\u8457\u6548\u679c\uff0c\u56e0\u6b64\u5bf9\u8fd9\u4e00\u5242\u91cf\u7684\u4f0a\u5339\u5355\u6297\u4f7f\u7528\u53ca\u5176\u76f8\u5173\u6bd2\u6027\u7684\u5408\u7406\u6027\u503c\u5f97\u8fdb\u4e00\u6b65\u63a2\u8ba8\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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34.3 \u4e0e\u4f0a\u5339\u5355\u6297\u8054\u5408\u6cbb\u7597<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u4f0a\u5339\u5355\u6297\u4e0e\u5176\u4ed6\u514d\u75ab\u8c03\u8282\u5242\u3001\u6297\u8840\u7ba1\u751f\u6210\u836f\u7269\u3001\u5316\u7597\u836f\u7269\u6216\u9776\u5411\u836f\u7269\u7684\u4e0d\u540c\u7ec4\u5408\u65b9\u5f0f\u6b63\u5728\u88ab\u5e7f\u6cdb\u7814\u7a76\u3002\u8fd9\u4e9b\u8054\u5408\u6cbb\u7597\u7684\u8bbe\u8ba1\u539f\u5219\u5f80\u5f80\u57fa\u4e8e\u9009\u7528\u80fd\u591f\u8bf1\u5bfc\u514d\u75ab\u539f\u6027\u7ec6\u80de\u6b7b\u4ea1\u7684\u836f\u7269\u3002\u9274\u4e8e\u653e\u7597\u4e5f\u80fd\u5f15\u53d1\u514d\u75ab\u539f\u6027\u7ec6\u80de\u6b7b\u4ea1\uff0c\u5173\u4e8e\u653e\u7597\u8054\u5408\u4f0a\u5339\u5355\u6297\u589e\u5f3a\u4f53\u5916\u6297\u80bf\u7624\u6548\u679c\u7684\u62a5\u9053\u6fc0\u53d1\u4e86\u591a\u9879\u4e34\u5e8a\u7814\u7a76\uff0c\u4ee5\u8fdb\u4e00\u6b65\u63a2\u8ba8\u8fd9\u4e00\u73b0\u8c61\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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34.4 \u5316\u7597<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u76ee\u524d\u5df2\u53d1\u5e03\u7684\u5173\u4e8e\u5316\u7597\u8054\u5408\u4f0a\u5339\u5355\u6297\u6cbb\u7597\u9ed1\u8272\u7d20\u7624\u7684\u7814\u7a76\u5305\u62ec\uff1a<\/p>\n

1.<\/strong> \u8fbe\u5361\u5df4\u55ea(DTIC):<\/strong> \u4e00\u9879III\u671f\u8bd5\u9a8c\u6bd4\u8f83\u4e86\u8fbe\u5361\u5df4\u55ea\u4e0e\u4f0a\u5339\u5355\u6297\uff0810mg\/kg\uff09\u8054\u5408\u4e00\u7ebf\u6cbb\u7597\u665a\u671f\u9ed1\u8272\u7d20\u7624\u60a3\u8005\u7684\u6548\u679c\uff0c\u663e\u793a\u8054\u5408\u6cbb\u7597\u63d0\u9ad8\u4e86\u751f\u5b58\u7387\u3002\u7136\u800c\uff0c\u4e2d\u4f4d\u751f\u5b58\u83b7\u76ca\u4ec5\u4e3a2.1\u4e2a\u6708\uff0c\u8fd9\u4e00\u7ed3\u679c\u4ee4\u4eba\u5931\u671b\uff0c\u5e76\u4e14\u8054\u5408\u7528\u836f\u7684\u6548\u679c\u5e76\u4e0d\u88ab\u8ba4\u4e3a\u4f18\u4e8e\u5355\u72ec\u4f7f\u7528\u4f0a\u5339\u5355\u6297\u3002\u957f\u671f\u751f\u5b58\u7387\u4e3a20%\uff0c\u8868\u660e\u8054\u5408\u6cbb\u7597\u5e76\u65e0\u4f18\u52bf\uff0c\u800c\u4e14\u8fd9\u79cd\u975e\u514d\u75ab\u539f\u6027\u5316\u7597\u4e0e\u4f0a\u5339\u5355\u6297\u7684\u8054\u5408\u4f7f\u7528\u5728\u4e34\u5e8a\u4e0a\u5e76\u672a\u5e7f\u6cdb\u91c7\u7528\u3002<\/p>\n

2. \u798f\u83ab\u53f8\u6c40(Fotemustine): <\/strong>\u5728\u4e00\u9879\u5f00\u653e\u6807\u7b7e\u5355\u7ec4II\u671f\u8bd5\u9a8c\u4e2d\uff0c86\u540d\u665a\u671f\u9ed1\u7d20\u7624\u60a3\u8005\uff0c\u5305\u62ec20\u540d\u65e0\u75c7\u72b6\u8111\u8f6c\u79fb\u60a3\u8005\uff0c\u63a5\u53d7\u4e86\u8bf1\u5bfc\u6cbb\u7597\uff0c\u6bcf3\u5468\u9759\u8109\u6ce8\u5c0410mg\/kg\u4f0a\u5339\u6728\u5355\u6297\uff0c\u51714\u4e2a\u5242\u91cf\uff0c\u540c\u65f6\u6bcf\u5468\u6ce8\u5c04100mg\/m2\u798f\u83ab\u53f8\u6c40\uff0c\u6301\u7eed3\u5468\u3002\u4ece\u7b2c9\u5468\u5230\u7b2c24\u5468\uff0c\u6bcf3\u5468\u6ce8\u5c04\u4e00\u6b21\u798f\u83ab\u53f8\u6c40\u3002\u8bc1\u5b9e\u4e34\u5e8a\u53cd\u5e94\u7684\u60a3\u8005\u4ece\u7b2c24\u5468\u5f00\u59cb\u8fdb\u884c\u7ef4\u6301\u6cbb\u7597\uff0c\u6bcf12\u5468\u4f7f\u7528\u4f0a\u5339\u5355\u6297\uff0c\u6bcf3\u5468\u4f7f\u7528\u798f\u83ab\u53f8\u6c40\u3002\u5728\u7814\u7a76\u4eba\u7fa4\u4e2d\uff0c46.5%\u7684\u60a3\u8005\u5b9e\u73b0\u4e86\u75be\u75c5\u63a7\u5236\uff0c50%\u7684\u8111\u8f6c\u79fb\u60a3\u8005\u5b9e\u73b0\u4e86\u75be\u75c5\u63a7\u5236\u3002\u4f46\u7531\u4e8e\u5176\u8f83\u5927\u7684\u6bd2\u6027\uff0c55%\u7684\u60a3\u8005\u51fa\u73b03\u7ea7\u62164\u7ea7\u6cbb\u7597\u76f8\u5173\u4e0d\u826f\u4e8b\u4ef6\u3002\u7531\u4e8e\u6297PD1\u5355\u836f\u6cbb\u7597\u7684\u51fa\u73b0\uff0c\u8fd9\u79cd\u8054\u5408\u7597\u6cd5\u5f88\u5c11\u4f7f\u7528\u3002<\/p>\n

3. \u5361\u94c2\/\u7d2b\u6749\u9187: <\/strong>\u4e00\u9879\u968f\u673aII\u671f\u8bd5\u9a8c\u6bd4\u8f83\u4e86\u5361\u94c2+\u7d2b\u6749\u9187\u548c\u4f0a\u5339\u5355\u6297\uff084\u6b21\u5242\u91cf\uff0c3mg\/kg\uff09\u4e0e\u8fd9\u4e9b\u836f\u7269\u7684\u987a\u5e8f\u6cbb\u7597\u3002\u53c2\u4e0e\u7814\u7a76\u7684\u9ed1\u8272\u7d20\u7624\u7c7b\u578b\u5305\u62ec\u76ae\u80a4\u3001\u7c98\u819c\u3001\u773c\u90e8\u53ca\u672a\u77e5\u539f\u53d1\u90e8\u4f4d\u7684\u9ed1\u8272\u7d20\u7624\u60a3\u8005\u3002\u6839\u636e\u514d\u75ab\u76f8\u5173\u53cd\u5e94\u6807\u51c6(irRC)\uff0c14\u540d\u53ef\u8bc4\u4f30\u60a3\u8005\u572824\u5468\u7684\u7f13\u89e3\u7387(RR)\u4e3a35.7%\uff0c\u75be\u75c5\u63a7\u5236\u7387(DCR)\u4e3a64.3%\uff0c63%\u7684\u60a3\u8005\u51fa\u73b03-4\u7ea7\u4e0d\u826f\u4e8b\u4ef6\u3002\u76ee\u524d\uff0c\u7531\u4e8e\u6297PD1\u5355\u836f\u6cbb\u7597\u53ca\u6297CTLA4\u548c\u6297PD1\u8054\u5408\u6cbb\u7597\u7684\u9ad8\u6548\u6027\uff0c\u6574\u4f53\u5316\u7597-\u514d\u75ab\u8054\u5408\u6cbb\u7597\u7684\u4f7f\u7528\u5728\u9ed1\u8272\u7d20\u7624\u6cbb\u7597\u4e2d\u5df2\u88ab\u9650\u5236\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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34.5 \u6297\u8840\u7ba1\u751f\u6210\u5242<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

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\u5728\u4e00\u9879II\u671f\u7814\u7a76\u4e2d\uff0c46\u4f8b\u8f6c\u79fb\u6027\u9ed1\u8272\u7d20\u7624\u60a3\u8005\u63a5\u53d7\u4e86\u4f0a\u5339\u5355\u6297\uff08\u5242\u91cf\u4e3a3\u621610 mg\/kg\uff09\u548c\u8d1d\u4f10\u5355\u6297\uff08\u4e00\u79cd\u9488\u5bf9VEGF\u7684\u5355\u514b\u9686\u6297\u4f53\uff0c\u5242\u91cf\u4e3a7.5\u621615 mg\/kg\uff09\u7684\u8054\u5408\u6cbb\u7597\u3002\u6cbb\u7597\u65b9\u6848\u5305\u62ec\u521d\u59cb\u76844\u4e2a\u5242\u91cf\uff0c\u6bcf3\u5468\u4e00\u6b21\uff0c\u95f4\u96944\u5468\uff0c\u4e4b\u540e\u6bcf12\u5468\u7ef4\u6301\u4e00\u6b21\u6cbb\u7597\u3002\u6574\u4f53\u75be\u75c5\u63a7\u5236\u7387\u8fbe\u5230\u4e8667.4%\uff0c\u5176\u4e2d\u5305\u62ec8\u4f8b\u90e8\u5206\u7f13\u89e3\u548c22\u4f8b\u75c5\u60c5\u7a33\u5b9a\u3002\u4e2d\u4f4d\u751f\u5b58\u671f\u4e3a25.1\u4e2a\u6708\u3002\u514d\u75ab\u76f8\u5173\u4e0d\u826f\u4e8b\u4ef6\uff08irAEs\uff09\u5305\u62ec1\u4f8b\u5de8\u7ec6\u80de\u52a8\u8109\u708e\u30012\u4f8b\u809d\u708e\u548c2\u4f8b\u8461\u8404\u819c\u708e\u3002\u5728\u6cbb\u7597\u671f\u95f4\u8fdb\u884c\u7684\u80bf\u7624\u6d3b\u68c0\u4e2d\uff0c\u89c2\u5bdf\u5230\u4e86\u5e7f\u6cdb\u7684CD8(+) T\u7ec6\u80de\u548c\u5de8\u566c\u7ec6\u80de\u6d78\u6da6\u3002\u521d\u6b65\u7ecf\u9a8c\u8868\u660e\uff0c\u8d1d\u4f10\u5355\u6297\u4e0e\u4f0a\u5339\u5355\u6297\u7684\u8054\u5408\u6cbb\u7597\u5728\u5b89\u5168\u6027\u65b9\u9762\u8868\u73b0\u826f\u597d\uff0c\u8fd9\u8fdb\u4e00\u6b65\u6307\u51fa\u4e86VEGF-A\u963b\u65ad\u5728\u708e\u75c7\u53cd\u5e94\u3001\u6dcb\u5df4\u7ec6\u80de\u8fc1\u79fb\u548c\u514d\u75ab\u8c03\u8282\u65b9\u9762\u7684\u6f5c\u5728\u4f5c\u7528\uff0c\u9700\u8981\u8fdb\u4e00\u6b65\u7684\u7814\u7a76\u6765\u63a2\u7d22\u548c\u7406\u89e3\u8fd9\u4e9b\u673a\u5236\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

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\u672c\u6587\u7531Oncolab\u5fae\u4fe1\u516c\u4f17\u53f7\u7ffb\u8bd1\u6574\u7406\u81eaOncoimmunology: A Practical Guide for Cancer Immunotherapy\uff0c\u4ec5\u7528\u4e8e\u5b66\u4e60\u4ea4\u6d41\u4f7f\u7528\uff0c\u5982\u9700\u8d2d\u4e70\u539f\u7248\u4e66\u7c4d\u53ef\u70b9\u51fb\u9605\u8bfb\u539f\u6587\u8d2d\u4e70\u3002<\/span>
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\u2014 THE  END \u2014<\/span><\/p>\n


<\/p>\n

\u6765\u6e90 | Oncoimmunology: A Practical Guide <\/span><\/p>\n

for Cancer Immunotherapy<\/span><\/p>\n

\u521d\u7a3f\u7ffb\u8bd1 | \u5ed6\u5a9b<\/span><\/p>\n

\u56fe\u6587\u6392\u7248 | \u5415\u601d\u8d24 \u8521\u5029\u8587<\/span><\/span><\/p>\n

\u5ba1\u6838\u4fee\u6539 | \u738b\u5764<\/span><\/p>\n

\uff08\u8f6c\u8f7d\u8bf7\u4fdd\u7559\u6b64\u90e8\u5206\u5185\u5bb9\uff09<\/span><\/strong><\/p>\n

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\u2589  \u5f80\u671f\u63a8\u9001\u5408\u8f91<\/strong><\/strong><\/section>\n
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\u80bf\u7624\u514d\u75ab\u5b66\u6700\u65b0\u6587\u732e<\/span><\/a>
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\u514d\u75ab\u5b66\u62fe\u9057\u7cfb\u5217<\/a><\/span><\/p>\n

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