大分での肺がん診療

　近々開催される米国臨床腫瘍学会年次総会（ASCO2015）で、抗PD-L1抗体の早期臨床試験結果が報告されるそうです。
　
　In this phase Ib study, patients with untreated NSCLC received one of three standard platinum-based chemotherapy regimens (paclitaxel/carboplatin, pemetrexed [Alimta]/carboplatin, or nab-paclitaxel [Abraxane]/carboplatin) with MPDL3280A, an antibody targeting PD-L1. Early results from the first 37 patients showed impressive response rates of between 60% to 75%, comparing favorably with historical outcomes with chemotherapy alone, where historical response rates from randomized trials are around 30% to 35%. In addition, two complete responses have been documented, with no evidence of lung cancer or computed tomography scans.
　Researchers say the combination therapy was well tolerated by patients, with no unexpected toxicities. The most frequently reported adverse events were linked to use of chemotherapy, investigators reported, including nausea, fatigue, and constipation. Side effects associated with MPDL3280A use included anemia, low levels of neutrophils, and low platelet counts.

　未治療進行非小細胞肺癌患者さんを対象に、カルボプラチン＋パクリタキセル、カルボプラチン＋ペメトレキセド、カルボプラチン＋アブラキサンのいずれかの併用療法に抗PD-L1抗体であるMPDL3280Aを上乗せしたところ、37人を解析した時点での奏効割合は60-75%で、一般的な併用化学療法の奏効割合である30-35%と比較して高そうだ、とのことでした。2人の完全奏効（ＣＴ画像上、病巣が消失）を含むとのこと。
　毒性の面では貧血、好中球減少、血小板減少といった骨髄毒性が高まる傾向にあるとのことで、いわゆる"more toxic, more effective"な治療になりそうですが、楽しみです。