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研究者说｜Heinz-Josef Lenz教授关于CheckMate-8HW的四问四答

2024年12月12日

来源：肿瘤资讯

CheckMate 8HW会怎样影响1L MSI-H/dMMR mCRC临床实践？

Prof.Heinz-Josef Lenz: CheckMate 8HW is a large randomized phase III clinical trial comparing NIVO alone, NIVO IPI versus chemotherapy

From the data cutoff after 31 months，you can see here that the hazard ratio between the progression-free survival curves have a 0.21, and the two-year progression-free survival was 72% versus 14%, showing incredible efficacy of a dual immune checkpoint combination in MSI-H tumors. So I think this will change the way we have to consider immunotherapy in the first-line setting for MSI-H tumors.

双免的安全性如何？

Prof.Heinz-Josef Lenz: when you use one milligram per kilogram every six weeks, there is no additional toxicity compared to NIVO alone. And that's actually shown and reproduced in the 8HW study. So for me, there is no doubt about it.

So for me, the combination is a more effective regimen.

如何看待PFS2数据及治疗方案的序贯选择？

Prof.Heinz-Josef Lenz: I think the rationale to look at PFS2 is really to understand the clinical impact of subsequent treatments on clinical efficacy. And I think I'm firstly very convinced that sequence of treatments matter. I always talk about this that you should always start with the best treatment first.

I think immunotherapy particularly if you treat it in earlier lines of treatment may have a significant impact on the efficacy of subsequent treatments. So I think for the reason you should always treat with the best treatment first and moving immunotherapy as early as possible to potentially open up the opportunity to increase sensitivity of your subsequent treatments.

I think PSF2 gives us an indication in these trials that when you do keep immunotherapy first, that you maintain the clinical efficacy beyond your treatment. if immunotherapy (is used first, it can maintain clinical efficacy )for subsequent treatments.

编者译：我认为观察PFS2数据的目的在于理解后续治疗对临床疗效的影响。我坚信治疗顺序至关重要，我一直强调应从最佳治疗开始。

我认为特别是在更早的治疗线中引入免疫疗法，可能会显著影响后续治疗的疗效。基于这一点，我们应尽可能早地使用免疫疗法，从而有可能提高后续治疗的敏感性。

这些试验中的PFS2数据表明，当首先使用免疫治疗时，其临床疗效可以在后续治疗中得以维持。

是否需要优选患者使用双免治疗？

Prof.Heinz-Josef Lenz: Based on the 8HW（CheckMate 8HW）study, all subgroups actually benefited, including those with BRAF mutant, including those with KRAS mutant, including patients with peritoneal disease, and including those with liver metastasis. In fact, what was astonishing is that although the number of Asian patients is small, this patient population benefited the most and those with liver lesions benefited the most.

So I don't think based on the CheckMate 8HW that there would be any groups excluded.

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