{"id":3193,"date":"2023-07-26T22:57:49","date_gmt":"2023-07-26T14:57:49","guid":{"rendered":"http:\/\/oncolab.cn\/index.php\/2023\/07\/26\/%e8%82%bf%e7%98%a4%e5%85%8d%e7%96%ab%e5%ad%a6-%e7%ac%ac23%e7%ab%a0%ef%bc%9a-pd-l1%e5%92%8c%e5%85%b6%e4%bb%96%e5%85%8d%e7%96%ab%e5%ad%a6%e8%af%8a%e6%96%ad%e5%b7%a5%e5%85%b7%ef%bc%88%e4%b8%8a%ef%bc%89\/"},"modified":"2023-07-26T22:57:49","modified_gmt":"2023-07-26T14:57:49","slug":"%e8%82%bf%e7%98%a4%e5%85%8d%e7%96%ab%e5%ad%a6-%e7%ac%ac23%e7%ab%a0%ef%bc%9a-pd-l1%e5%92%8c%e5%85%b6%e4%bb%96%e5%85%8d%e7%96%ab%e5%ad%a6%e8%af%8a%e6%96%ad%e5%b7%a5%e5%85%b7%ef%bc%88%e4%b8%8a%ef%bc%89","status":"publish","type":"post","link":"http:\/\/oncolab.cn\/index.php\/2023\/07\/26\/%e8%82%bf%e7%98%a4%e5%85%8d%e7%96%ab%e5%ad%a6-%e7%ac%ac23%e7%ab%a0%ef%bc%9a-pd-l1%e5%92%8c%e5%85%b6%e4%bb%96%e5%85%8d%e7%96%ab%e5%ad%a6%e8%af%8a%e6%96%ad%e5%b7%a5%e5%85%b7%ef%bc%88%e4%b8%8a%ef%bc%89\/","title":{"rendered":"\u80bf\u7624\u514d\u75ab\u5b66-\u7b2c23\u7ae0\uff1a PD-L1\u548c\u5176\u4ed6\u514d\u75ab\u5b66\u8bca\u65ad\u5de5\u5177\uff08\u4e0a\uff09"},"content":{"rendered":"
\n
\n
\n
\n
\n


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

\n
\n

23.1 \u5f15\u8a00<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n

\u968f\u7740\u514d\u75ab\u7597\u6cd5\u52a0\u5165\u4e3b\u6d41\u764c\u75c7\u6cbb\u7597\u624b\u6bb5\u7684\u884c\u5217\uff0c\u4eba\u4eec\u4fbf\u5f00\u59cb\u5173\u6ce8\u4e0e\u53cd\u5e94\u6027\u548c\u8010\u836f\u6027\u6709\u5173\u7684\u751f\u7269\u6807\u8bb0\u7269\u3002\u6cbb\u7597\u524d\u751f\u7269\u6807\u8bb0\u7269\u53ef\u80fd\u6709\u52a9\u4e8e\u60a3\u8005\u9009\u62e9\u66f4\u52a0\u5408\u7406\u7684\u6cbb\u7597\u65b9\u6cd5\uff0c\u751a\u81f3\u53ef\u80fd\u5bf9\u7b5b\u9009\u51fa\u975e\u5e38\u89c4\u53cd\u5e94\u6a21\u5f0f\uff08\u5982\u5ef6\u8fdf\u53cd\u5e94\u6216\u80bf\u7624\u5728\u660e\u663e\u6d88\u9000\u524d “\u8fdb\u5c55”\uff09\u7684\u60a3\u8005\u4e5f\u6709\u5e2e\u52a9\u3002\u8fd9\u4e9b\u751f\u7269\u6807\u8bb0\u7269\u4e5f\u53ef\u80fd\u6709\u52a9\u4e8e\u9884\u6d4b\u67d0\u4e9b\u4e25\u91cd\u7684\u514d\u75ab\u76f8\u5173\u7684\u4e0d\u826f\u4e8b\u4ef6\u3002\u6b64\u5916\uff0c\u6602\u8d35\u7684\u6cbb\u7597\u8d39\u7528\u4e5f\u662f\u63a8\u52a8\u8be5\u9886\u57df\u6df1\u5165\u7814\u7a76\u7684\u4e00\u4e2a\u56e0\u7d20\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n

\u7814\u7a76\u6700\u5145\u5206\u7684\u5f71\u54cd\u6cbb\u7597\u53cd\u5e94\u7684\u56e0\u7d20\u662f\u901a\u8fc7\u514d\u75ab\u7ec4\u5316\u6cd5\u6d4b\u91cf\u7684PD-L1\u86cb\u767d\u8868\u8fbe\u3002\u7814\u7a76\u8868\u660e\uff0c\u5728\u591a\u79cd\u5b9e\u4f53\u80bf\u7624\u7c7b\u578b\u4e2d\uff0c\u6297PD -1\u548cPD-L1\u5355\u836f\u6cbb\u7597\u7684\u5ba2\u89c2\u5e94\u7b54\u7387(ORR)\u90fd\u6bd4\u8f83\u9ad8\uff0c\u8fd1\u671f\u53c8\u53d1\u73b0\u8054\u5408\u6297PD -1\/CTLA-4\u963b\u65ad\u5242\u53ef\u7528\u4e8e\u6cbb\u7597\u975e\u5c0f\u7ec6\u80de\u80ba\u764c(NSCLC)\u60a3\u8005\u3002\u672c\u7ae0\u5c06\u7efc\u8ff0PD-L1\u4f5c\u4e3a\u751f\u7269\u6807\u5fd7\u7269\u5728\u591a\u79cd\u80bf\u7624\u4e2d\u7684\u5e94\u7528\uff0c\u4ee5\u53ca\u5176\u5728\u4e34\u5e8a\u5b9e\u8df5\u4e2d\u5b9e\u65bd\u7684\u95ee\u9898\uff0c\u4f8b\u5982\u4e0d\u540c\u7684\u5546\u4e1a\u5316PD-L1\u68c0\u6d4b\u65b9\u6cd5\u3002\u540c\u65f6\u4e5f\u5c06\u4ecb\u7ecd\u5176\u4ed6\u65b0\u5174\u7684\u57fa\u4e8e\u80bf\u7624\u7ec4\u7ec7\u7684\u751f\u7269\u6807\u5fd7\u7269\uff0c\u5982\u80bf\u7624\u7684\u7a81\u53d8\u8d1f\u8377\u3001CD8+<\/sup>\u80bf\u7624\u6d78\u6da6\u6dcb\u5df4\u7ec6\u80de(TIL)\u5bc6\u5ea6\u3001T\u7ec6\u80de\u514b\u9686\u7814\u7a76\u3001\u57fa\u56e0\u8868\u8fbe\u7279\u5f81\u4ee5\u53ca\u5916\u5468\u8840\u751f\u7269\u6807\u5fd7\u7269\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n


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

\n
\n

23.2  \u6297PD-1\/PD-L1\u7597\u6cd5\u53caPD-L1\u8868\u8fbe\u4f5c\u4e3a\u751f\u7269\u6807\u5fd7\u7269\u7684\u4f5c\u7528<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

23.2.1 \u5b9e\u4f53\u7624\u7684\u65e9\u671f\u6cbb\u7597\u7ecf\u9a8c<\/p>\n<\/section>\n

\n
\n
\n

\u901a\u8fc7\u514d\u75ab\u7ec4\u7ec7\u5316\u5b66(IHC)\u68c0\u6d4bPD-L1\u7684\u8868\u8fbe\u53ef\u80fd\u4e0e\u6297PD-1\u7684\u5e94\u7b54\u6709\u5173\uff0c\u8fd9\u6837\u7684\u7b2c\u4e00\u4e2a\u8054\u60f3\u6765\u81ea2010\u5e74\u62a5\u9053\u7684\u6297PD-1\u7684I\u671f\u7814\u7a76(MDX1106\uff0cnivolumab)\u3002\u5728\u8fd9\u9879\u7814\u7a76\u4e2d\uff0c\u6765\u81ea\u4e8e9\u540d\u60a3\u8005\u63d0\u4f9b\u7684\u53ef\u4f9b\u7814\u7a76\u7684\u7ec4\u7ec7\u663e\u793a\uff0c\u7ec6\u80de\u819c\u8868\u9762PD-L1\u7684\u8868\u8fbe\u4e0e\u80fd\u5426\u4ea7\u751f\u53cd\u5e94\u4e4b\u95f4\u5b58\u5728\u4e00\u5b9a\u7684\u76f8\u5173\u6027\u3002\u8be5\u53d1\u73b0\u968f\u540e\u5728\u6709\u6cbb\u7597\u524d\u80bf\u7624\u6837\u672c\u7684\u6269\u5c55\u7814\u7a76\u4e2d\u5f97\u5230\u8fdb\u4e00\u6b65\u8bc1\u5b9e\uff1a42\u540d\u60a3\u8005\u60a3\u6709\u591a\u79cd\u80bf\u7624\u7c7b\u578b\uff08\u5305\u62ec\u9ed1\u8272\u7d20\u7624\u3001\u975e\u5c0f\u7ec6\u80de\u80ba\u764c\u3001\u80be\u7ec6\u80de\u764c\u3001\u524d\u5217\u817a\u764c\u548c\u7ed3\u76f4\u80a0\u764c\uff09\u3002\u5f53\u8bc4\u4f30\u80bf\u7624\u7ec6\u80dePD-L1\u7684\u8868\u8fbe\u65f6\uff0cPD-L1\u9634\u6027\u7684\u60a3\u8005\u6ca1\u6709\u4e00\u4f8b\u5bf9\u8be5\u7597\u6cd5\u4ea7\u751f\u53cd\u5e94(0\/17)\uff0c\u800c\u514d\u75ab\u7ec4\u5316PD-L1\u9633\u6027\u7684\u80bf\u7624\u60a3\u8005\u670936%(9\/25)\u7684\u60a3\u8005\u6709\u5ba2\u89c2\u53cd\u5e94(p=0.006)\u3002<\/p>\n

2014\u5e74\u62a5\u9053\u7684\u53e6\u4e00\u9879\u91cc\u7a0b\u7891\u5f0f\u7684\u4e34\u5e8a\u8bd5\u9a8c\u8bc4\u4f30\u4e86\u6297PD-L1\u6297\u4f53(Atezolizumab)\u5728\u4e0d\u540c\u5b9e\u4f53\u6076\u6027\u80bf\u7624(\u975e\u5c0f\u7ec6\u80de\u80ba\u764c\u3001\u9ed1\u8272\u7d20\u7624\u3001\u80be\u764c\u3001\u5934\u9888\u90e8\u3001\u4e73\u817a\u3001\u7ed3\u76f4\u80a0\u7b49)\u4e2d\u7684\u6d3b\u6027\uff0c\u5e76\u5c06PD-L1\u4f5c\u4e3a\u6f5c\u5728\u7684\u53cd\u5e94\u751f\u7269\u6807\u5fd7\u7269\u8fdb\u884c\u4e86\u7814\u7a76\u3002\u7136\u800c\uff0c\u4ed6\u4eec\u5f3a\u8c03PD-L1\u5728\u514d\u75ab\u7ec6\u80de\u4e0a\u8868\u8fbe\uff0c\u800c\u4e0d\u5728\u80bf\u7624\u7ec6\u80de\u3002\u4ed6\u4eec\u6307\u51fa\u514d\u75ab\u7ec6\u80de\u4e0aPD-L1\u7684\u8868\u8fbe\u4e0e\u60a3\u8005\u7684ORR\u663e\u8457\u76f8\u5173(PD-L1(+)\u548cPD-L1(\u2212)\u80bf\u7624\u5206\u522b\u4e3a45%\u548c16%)\u3002\u968f\u540e\uff0c\u5927\u591a\u6570\u5173\u4e8ePD-1\/PD-L1\u963b\u65ad\u5242\u7684\u4e34\u5e8a\u8bd5\u9a8c\u90fd\u8bc4\u4f30\u4e86\u6cbb\u7597\u524d\u80bf\u7624\u6807\u672c\u4e2d\u80bf\u7624\u548c\/\u6216\u6d78\u6da6\u514d\u75ab\u7ec6\u80de\u7684PD-L1\u86cb\u767d\u8868\u8fbe\u4ee5\u53ca\u4e0e\u4e34\u5e8a\u7ed3\u679c\u7684\u5173\u7cfb\u3002\u4e0b\u9762\u603b\u7ed3\u4e86\u5176\u4e2d\u4e00\u4e9b\u4e3b\u8981\u7684\u4e34\u5e8a\u8bd5\u9a8c\uff0c\u56fe23.1<\/span>\u4e2d\u663e\u793a\u4e86\u6309PD-L1\u72b6\u6001\u5206\u7c7b\u7684\u7efc\u5408\u53cd\u5e94\u7387\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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


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

\n
\n

Fig. 23.1<\/span> \u514d\u75ab\u7ec4\u7ec7\u5316\u5b66\u68c0\u6d4b\u80bf\u7624\u6807\u672c\u4e2dPD-L1\u7684\u8868\u8fbe\u4e0e\u591a\u79cd\u5b9e\u4f53\u80bf\u7624\u7c7b\u578b\u5bf9\u6297PD-1\/L1\u7684\u5ba2\u89c2\u53cd\u5e94\u7387(ORR)\u76f8\u5173\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

23.2.2 \u975e\u5c0f\u7ec6\u80de\u80ba\u764c\uff08NSCLC\uff09<\/strong><\/p>\n<\/section>\n

\n
\n
\n

\u5c31PD-1\/PD-L1\u963b\u6ede\u5242\u7684\u6d3b\u6027\u7814\u7a76\u800c\u8a00\uff0c\u975e\u5c0f\u7ec6\u80de\u80ba\u764c\u53ef\u80fd\u662f\u7814\u7a76\u6700\u5145\u5206\u7684\u80bf\u7624\u7c7b\u578b\u30029\u9879\u4e34\u5e8a\u5b9e\u9a8c\u663e\u793a\uff0c\u67091725\u4f8b\u975e\u5c0f\u7ec6\u80de\u80ba\u764c\u60a3\u8005\u63a5\u53d7\u4e86\u4e09\u79cd\u4e0d\u540c\u7684\u6297PD-1\u6216\u6297PD- L1\u7597\u6cd5[nivolumab, pembrolizumab(\u4ebaIgG4\u6297pd -1\u5355\u514b\u9686\u6297\u4f53)\u548catezolizumab]\u4e2d\u7684\u4e00\u79cd\u6cbb\u7597\uff0c\u4ed6\u4eec\u7684\u603b\u4f53ORR\u4e3a17%\u3002 \u4ece\u6240\u6709\u60a3\u8005\u6536\u96c6\u7684\u6570\u636e\u2014\u2014\u65e0\u8bba\u4ed6\u4eec\u662f\u5426\u5728\u4e00\u7ebf\u6216\u66f4\u9ad8\u7ea7\u522b\u7684\u73af\u5883\u4e2d\u63a5\u53d7\u836f\u7269\uff0c\u6216\u7528\u4e8e\u786e\u5b9a PD-L1 \u9633\u6027\u7684\u68c0\u6d4b\u65b9\u6cd5\u2014\u2014\u663e\u793a PD-L1(+) \u7684\u80bf\u7624\u60a3\u8005\u7684 ORR \u4e3a 33%\uff0c PD-L1(\u2212) \u80bf\u7624\u60a3\u8005\u7684ORR\u4e3a11%\u3002\u5f53\u6bcf\u79cd\u6cbb\u7597\u65b9\u6cd5\u88ab\u5355\u72ec\u8bc4\u4f30\u65f6\uff0c\u8fd9\u79cd\u5173\u7cfb\u4fdd\u6301\u4e0d\u53d8\uff1anivolumab\u5355\u6297\uff085\u9879\u7814\u7a76\uff0c538\u540d\u6cbb\u7597\u60a3\u8005)\u7684ORR\u4e3a30%PD-L1(+)\u4e0e13%PD-L1(\u2212)\uff1bpembrolizumab\u5355\u6297(2\u9879\u7814\u7a76\uff0c1015\u540d\u6cbb\u7597\u60a3\u8005)\u7684ORR\u4e3a33%PD-L1(+)\u4e0e11%PD-L1(\u2212)\uff1batezolizumab\u5355\u6297(2\u9879\u7814\u7a76\uff0c190\u540d\u6cbb\u7597\u60a3\u8005)\u7684ORR\u4e3a 42%PD-L1(+)\u4e0e11%PD-L1(\u2212)\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n

\u8fd1\u671f\u7684\u4e00\u9879\u7814\u7a76\u6bd4\u8f83\u4e86\u6297PD-1\u5355\u4e00\u7597\u6cd5\u548c\u8054\u5408\u6297PD-1\/CTLA-4\u963b\u65ad\u4f5c\u4e3aNSCLC\u60a3\u8005\u4e00\u7ebf\u6cbb\u7597\u7684\u6548\u679c\uff0c\u53d1\u73b0\u4e86\u4e24\u4e2a\u4e0ePD-L1\u4f5c\u4e3a\u751f\u7269\u6807\u5fd7\u7269\u6709\u5173\u7684\u6709\u8da3\u73b0\u8c61\u3002\u7b2c\u4e00\u4e2a\u53d1\u73b0\u662f\uff0c\u6cbb\u7597\u524d\u80bf\u7624\u5fae\u73af\u5883\u4e2dPD-L1\u6c34\u5e73\u7684\u589e\u52a0\u63d0\u9ad8\u4e86\u6297PD-1\u7684ORR\u3002\u503c\u5f97\u6ce8\u610f\u7684\u662f\uff0c\u8be5\u7ed3\u679c\u4e0e\u6839\u636ePD-L1\u72b6\u6001\u8fdb\u884c\u4e8c\u5206\u6cd5\u7684\u7ed3\u8bba\u76f8\u53cd\u3002\u7b2c\u4e8c\u4e2a\u503c\u5f97\u6ce8\u610f\u7684\u53d1\u73b0\u662f\uff0c\u6cbb\u7597\u524d\u80bf\u7624\u6807\u672c\u4e2dPD-L1\u8868\u8fbe\u6c34\u5e73\u7684\u589e\u52a0\u4e0d\u4ec5\u9884\u793a\u7740\u5bf9\u6297PD-1\u53cd\u5e94\u7684\u6539\u5584\uff0c\u800c\u4e14\u8fd8\u4e0e\u63a5\u53d7\u8054\u5408\u6cbb\u7597\u65b9\u6848\u7684\u60a3\u8005ORR\u7684\u589e\u52a0\u6709\u5173\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n

\u6b64\u5916\uff0c\u76f8\u5173\u4eba\u5458\u8fd8\u7814\u7a76\u4e86\u975e\u5c0f\u7ec6\u80de\u80ba\u764c\u60a3\u8005\u7684\u7ec4\u7ec7\u5b66\u4e9a\u578b\u3001\u6f5c\u5728\u7684\u57fa\u56e0\u6539\u53d8\u3001\u5438\u70df\u72b6\u6001\u3001PD-L1\u72b6\u6001\u548c\u6cbb\u7597\u6548\u679c\u7684\u5173\u7cfb\u3002\u4e9a\u578b\u7ec4\u5206\u6790\u8868\u660e\uff0c\u80bf\u7624\u7ec4\u7ec7\u5b66\u53ef\u80fd\u5f71\u54cdPD-L1\u7684\u8868\u8fbe\u548c\u6cbb\u7597\u53cd\u5e94\u4e4b\u95f4\u7684\u5173\u7cfb\uff0c\u5728\u975e\u9cde\u72b6NSCLC\u4e2d\uff0cPD-L1\u7684\u5bcc\u96c6\u4e0e\u53cd\u5e94\u76f8\u5173\uff0c\u4f46\u5728\u8868\u73b0\u4e3a\u9cde\u72b6\u7ec4\u7ec7\u5b66\u7684\u80bf\u7624\u4e2d\u5219\u65e0\u53cd\u5e94\u3002\u8fd9\u53ef\u80fd\u662f\u7531\u4e8ePD-L1\u5728\u80ba\u817a\u764c\u4e2d\u7684\u8868\u8fbe\u4e0eIFN-\u03b3\u6709\u5173\uff0c\u800cIFN-\u03b3\u4e0ePD-L1\u5728\u80ba\u9cde\u764c\u4e2d\u7684\u8868\u8fbe\u5219\u4e0d\u76f8\u5173\uff08\u89c1\u4e0b\u6587\u201c\u80bf\u7624\u5fae\u73af\u5883\u4e2dPD-L1\u8868\u8fbe\u7684\u610f\u4e49\u662f\u4ec0\u4e48?\u201d)\u3002 <\/p>\n

EGFR\u3001TP53\u548cKRAS\u57fa\u56e0\u7684\u7a81\u53d8\u90fd\u4e0ePD-L1\u8868\u8fbe\u589e\u52a0\u6709\u5173\uff0c\u901a\u5e38\u662f\u901a\u8fc7PI3K-AKT-mTOR\u901a\u8def\u7684\u6fc0\u6d3b\u3002\u5176\u4e2d\uff0cTP53\u548cKRAS\u7a81\u53d8\u4e0e\u8f83\u9ad8\u7684ORR\u76f8\u5173\uff0c\u800cEGFR\u7a81\u53d8\u88ab\u8ba4\u4e3a\u4e0e\u6297PD-1\u68c0\u67e5\u70b9\u963b\u65ad\u7684\u8010\u836f\u6027\u90e8\u5206\u76f8\u5173\u3002\u6700\u540e\uff0c\u51e0\u9879\u7814\u7a76\u62a5\u544a\u4e86\u6709\u5438\u70df\u53f2\u7684\u60a3\u8005\u7684ORR\u66f4\u9ad8\u6216PFS\u66f4\u957f\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

23.2.3 \u6ccc\u5c3f\u751f\u6b96\u7cfb\u7edf\u6076\u6027\u80bf\u7624(\u5c3f\u8def\u4e0a\u76ae\u764c\u548c\u80be\u764c)<\/p>\n<\/section>\n

\n
\n
\n

\u5c3f\u8def\u4e0a\u76ae\u764c(\u8180\u80f1\u764c\u3001\u8f93\u5c3f\u7ba1\u764c\u548c\u80be\u76c2\u764c)\u662f\u53e6\u4e00\u79cd\u5bf9PD-1\/PD-L1\u963b\u65ad\u9ad8\u5ea6\u654f\u611f\u7684\u80bf\u7624\u7c7b\u578b\u3002\u9488\u5bf9\u5c3f\u8def\u4e0a\u76ae\u764c\u7684\u5927\u591a\u6570\u4e34\u5e8a\u8bd5\u9a8c\u90fd\u8bc4\u4f30\u4e86\u6297PD-L1\u800c\u4e0d\u662f\u6297PD-1\u7684\u6d3b\u6027\u3002\u5728\u5305\u542b752\u540d\u5c3f\u8def\u4e0a\u76ae\u764c\u60a3\u8005\u76845\u4e2a\u4e0d\u540c\u7684\u76f8\u5173\u4e34\u5e8a\u8bd5\u9a8c\u4e2d\u89c2\u5bdf\u5230\uff0c\u4ed6\u4eec\u603b\u7684ORR\u4e3a16%\u3002<\/p>\n

\u6839\u636ePD-L1\u5728TME\u4e2d\u7684\u8868\u8fbe\u8fdb\u884c\u5206\u7ea7\u65f6\uff0c\u80bf\u7624\u6216\u8005\u514d\u75ab\u7ec6\u80dePD-L1(+)\u60a3\u8005\u7684ORR\u4e3a27%\uff0c\u800cPD-L1(\u2212)\u60a3\u8005\u7684ORR\u4e3a11%\u3002\u5f53\u6309\u6cbb\u7597\u836f\u7269\u7ec6\u5206\u65f6\uff0cPD-L1\u8868\u8fbe\u4e0e\u53cd\u5e94\u7684\u5173\u8054\u5e76\u4e0d\u53d6\u51b3\u4e8e\u6240\u63a5\u53d7\u7684\u6297PD-L1\u836f\u7269\u3002\u4f8b\u5982\uff0c\u5728\u963f\u7279\u73e0\u5355\u6297\u8bd5\u9a8c\uff083\u9879\u7814\u7a76\u548c 695 \u540d\u63a5\u53d7\u6cbb\u7597\u7684\u60a3\u8005\uff09\u4e2d\u89c2\u5bdf\u5230 PD-L1(+) \u60a3\u8005\u7684 ORR \u4e3a 27%\uff0c\u800c PD-L1(-) \u60a3\u8005\u7684 ORR \u4e3a 11%\uff0c\u5e76\u4e14\u5728\u4e00\u9879\u9488\u5bf9 42 \u540d\u60a3\u8005\u7684\u4e34\u5e8a\u8bd5\u9a8c\u4e2d\u53d1\u73b0 PD-L1(+) \u60a3\u8005\u7684 ORR \u4e3a 45%\uff0c\u800c PD-L1(-) \u60a3\u8005\u7684 ORR \u4e3a 0%\u3002<\/p>\n

\u503c\u5f97\u6ce8\u610f\u7684\u662f\uff0c\u552f\u4e00\u4e00\u9879\u5173\u6ce8\u6297PD-1\u836f\u7269\uff08\u7eb3\u6b66\u5355\u6297\uff0c67\u540d\u60a3\u8005\uff09\u7597\u6548\u7684\u7814\u7a76\u53d1\u73b0\uff0cPD-L1\uff08+\uff09\u548cPD-L1\uff08-\uff09\u80bf\u7624\u60a3\u8005\u7684ORR\u76f8\u4f3c\uff08\u5206\u522b\u4e3a24%\u548c26%\uff09\u3002\u867d\u7136\u6ca1\u6709\u89c2\u5bdf\u5230ORR\u7684\u5dee\u5f02\uff0c\u4f46\u4e0ePD-L1(\u2212)\u80bf\u7624\u76f8\u6bd4\uff0cPD-L1(+)\u80bf\u7624\u60a3\u8005\u7684\u4e2d\u4f4d\u603b\u751f\u5b58\u671f\u6709\u6240\u6539\u5584\u3002\u8be5\u7814\u7a76\u4ec5\u5173\u6ce8\u80bf\u7624\u7ec6\u80dePD-L1\u7684\u8868\u8fbe\u91cf\uff0c\u5e76\u5c06\u8868\u8fbe\u91cf\u8d85\u8fc71%\u8fd9\u4e2a\u9608\u503c\u7684\u80bf\u7624\u5b9a\u6027\u4e3aPD-L1(+)\uff0c\u8fd9\u6bd4\u4f7f\u7528\u6297PD-L1\u836f\u7269\u7814\u7a76\u65f6\u5212\u5b9a\u7684\u9608\u503c\u8981\u4f4e\u3002\u672a\u6765\u7684\u7814\u7a76\u65e0\u7591\u5c06\u96c6\u4e2d\u5728\u7814\u7a76\u514d\u75ab\u7ec6\u80de\u4e0aPD-L1\u7684\u8868\u8fbe\u6210\u5206\u662f\u5426\u80fd\u66f4\u597d\u5730\u5bf9\u7eb3\u6b66\u5355\u6297\u7684\u53cd\u5e94\u8fdb\u884c\u5206\u7ea7\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n

\u4e24\u9879\u4e13\u6ce8\u4e8e\u8f6c\u79fb\u6027\u80be\u7ec6\u80de\u764c(RCC)\u6cbb\u7597\u7684\u4e34\u5e8a\u8bd5\u9a8c\u62a5\u544a\u4e86\u6709\u5173PD-L1\u72b6\u6001\u53ca\u5176\u4e0e\u7597\u6548\u7684\u5173\u7cfb\u7684\u4fe1\u606f\u3002\u4e00\u9879\u7814\u7a76\u4f7f\u7528\u7eb3\u6b66\u5355\u6297(n=107)\uff0c\u53e6\u4e00\u9879\u7814\u7a76\u4f7f\u7528\u963f\u7279\u73e0\u5355\u6297(n=55)\uff0c\u4e24\u9879\u7814\u7a76\u7684\u603bORR\u4e3a19%\u3002\u5728\u8fd9\u4e24\u9879\u7814\u7a76\u4e2d\uff0cTME\u4e2d\u7684PD-L1\u8868\u8fbe\u6ca1\u6709\u660e\u663e\u7684\u76ca\u5904\u3002\u53e6\u4e00\u9879\u670910\u540d\u60a3\u8005\u53c2\u52a0\u7684\u5c0f\u578b\u7814\u7a76\u6bd4\u8f83\u4e86\u963f\u7279\u73e0\u5355\u6297\u4e0e\u8d1d\u4f10\u5355\u6297\uff08\u4eba\u6e90\u5316\u5355\u514b\u9686\u6297VEGF\uff09\u5728PD-L1\uff08+\uff09\u548cPD-L1\uff08-\uff09\u80bf\u7624\u4e4b\u95f4\u7684\u6d3b\u6027\uff0c\u4e5f\u6ca1\u6709\u53d1\u73b0\u5dee\u5f02\u3002\u5c31\u50cf\u80ba\u9cde\u72b6\u7ec6\u80de\u764c(\u4e0a\u6587\u8ba8\u8bba\u8fc7)\u4e00\u6837\uff0c\u8fd9\u79cd\u7f3a\u4e4f\u53cd\u5e94\u53ef\u80fd\u662f\u7531\u4e8e\u80be\u764c\u4e2dPD-L1\u7684\u8868\u8fbe\u4e0e\u5e72\u6270\u7d20-\u03b3\u7684\u8868\u8fbe\u65e0\u5173\uff0c\u8fd9\u4e0e\u8bb8\u591a\u5176\u4ed6\u5b9e\u4f53\u80bf\u7624\u7c7b\u578b\u76f8\u53cd\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

23.2.4 \u9ed1\u8272\u7d20\u7624<\/p>\n<\/section>\n

\n
\n
\n

\u5728\u6240\u7814\u7a76\u7684\u5b9e\u4f53\u80bf\u7624\u7c7b\u578b\u4e2d\uff0c\u665a\u671f\u9ed1\u8272\u7d20\u7624\u5bf9PD-1\/PD-L1\u963b\u65ad\u7684\u5e94\u7b54\u7387\u6700\u9ad8\u3002\u5305\u62ec871\u540d\u88ab\u6807\u6ce8\u4e86\u80bf\u7624PD-L1\u8868\u8fbe\u7684\u9ed1\u8272\u7d20\u7624\u60a3\u8005\u7684\u56db\u9879\u4e34\u5e8a\u8bd5\u9a8c\u8868\u660e\uff0c\u603b\u4f53ORR\u4e3a40%\u3002\u5176\u4e2dPD-L1(+)\uff08\u4ee5\u80bf\u7624\u7ec6\u80de\u4e2d\u6709\u8d85\u8fc75%\u7684PD-L1\u8868\u8fbe\u4e3a\u5206\u754c\u7ebf\uff09\u80bf\u7624\u60a3\u8005\u7684ORR\u4e3a53%\uff0c\u800cPD-L1(\u2212)\u80bf\u7624\u60a3\u8005\u7684ORR\u503c\u4e3a34%\u3002\u968f\u7740\u4e00\u4e9b\u8bd5\u9a8c\u7684\u6210\u719f\uff0c\u79d1\u7814\u4eba\u5458\u5df2\u7ecf\u53ef\u4ee5\u8bc4\u4f30\u5176\u4ed6\u7ec8\u70b9\uff0c\u5982\u65e0\u8fdb\u5c55\u751f\u5b58\uff08PFS\uff09\u548c\u603b\u4f53\u751f\u5b58\uff08OS\uff09\uff0c\u800c\u4e0d\u4ec5\u4ec5\u662fORR\u3002\u76ee\u524d\u53d1\u73b0\uff0cPD-L1(+)\u9ed1\u8272\u7d20\u7624\u60a3\u8005\u7684PFS\u548cOS\u6bd4PD-L1(\u2212)\u60a3\u8005\u66f4\u957f\u3002<\/p>\n

\u6b64\u5916\uff0cPD-L1\u8868\u8fbe\u6c34\u5e73\u8f83\u9ad8\u7684\u9ed1\u8272\u7d20\u7624\u60a3\u8005\u6bd4\u8868\u8fbe\u6c34\u5e73\u8f83\u4f4e\u7684\u9ed1\u8272\u7d20\u7624\u60a3\u8005\u66f4\u6709\u53ef\u80fd\u4ea7\u751f\u836f\u6548\uff0c\u8fd9\u4f7f\u4eba\u4eec\u5bf9\u8fde\u7eed\u53d8\u91cf\u7684\u4e8c\u5206\u8bc4\u5206\u7cfb\u7edf\u7684\u4f7f\u7528\u63d0\u51fa\u4e86\u8d28\u7591\u3002\u76ee\u524d\u5c1a\u672a\u786e\u5b9aBRAFV600E\u7a81\u53d8\u4e0ePD-L1\u8868\u8fbe\u6216\u60a3\u8005\u5bf9PD-1\/PD-L1\u963b\u65ad\u7684\u53cd\u5e94\u4e4b\u95f4\u7684\u5173\u8054\u3002\u8fd9\u4e5f\u5177\u6709\u91cd\u8981\u7684\u751f\u7269\u6807\u5fd7\u7269\u610f\u4e49\uff0c\u56e0\u4e3a\u5b83\u8868\u660e\u5728\u4e3a\u665a\u671f\u9ed1\u8272\u7d20\u7624\u60a3\u8005\u505a\u51fa\u6cbb\u7597\u65b9\u6cd5\u7684\u51b3\u5b9a\u65f6\uff0cBRAFV600E\u7a81\u53d8\u548cPD-L1\u8868\u8fbe\u5e94\u88ab\u89c6\u4e3a\u5355\u72ec\u7684\u751f\u7269\u6807\u5fd7\u7269\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n

\u76ee\u524d\u4e5f\u5c06PD-L1\u7684\u8868\u8fbe\u8bc4\u4f30\u4e3a\u9ed1\u8272\u7d20\u7624\u60a3\u8005\u5bf9\u53cc\u91cd\u6297PD-1\/CTLA-4\u68c0\u67e5\u70b9\u963b\u65ad\u53cd\u5e94\u7684\u6f5c\u5728\u751f\u7269\u6807\u5fd7\u7269\u3002\u4e0e\u63a5\u53d7\u6297PD-1\u5355\u836f\u6cbb\u7597\u7684\u60a3\u8005\u76f8\u6bd4\uff0cPD-L1\u7684\u8868\u8fbe\u5e76\u4e0d\u5f71\u54cd\u6297PD-1\/CTLA-4\u68c0\u67e5\u70b9\u8054\u5408\u963b\u65ad\u65b9\u6848\u89c2\u5bdf\u5230\u7684\u663e\u8457\u9ad8\u5e94\u7b54\u7387\uff0c\u8fd9\u8868\u660e\u8054\u5408\u963b\u65ad\u7597\u6cd5\u53ef\u80fd\u80fd\u591f\u201c\u514b\u670dPD-L1(\u2212)\u72b6\u6001\u201d\u3002\u6709\u4eba\u63d0\u51fa PD-L1\u7684\u8868\u8fbe\u5728\u672a\u6765\u7528\u4e8e\u5bf9\u4e0d\u540c\u65b9\u6848\u4e4b\u95f4\u7684\u60a3\u8005\u8fdb\u884c\u5206\u7c7b\uff0cPD-L1(+)\u60a3\u8005\u63a5\u53d7\u6297PD-1\u5355\u4e00\u6cbb\u7597\uff0c\u8fd9\u53ea\u4f1a\u4ea7\u751f\u8f83\u4f4e\u7684\u526f\u4f5c\u7528\uff0c\u800cPD-L1(\u2212)\u60a3\u8005\u66f4\u9002\u5408\u63a5\u53d7\u8054\u5408\u6297PD-1\/CTLA-4\u68c0\u67e5\u70b9\u963b\u65ad\u7597\u6cd5\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n

23.2.5 \u75c5\u6bd2\u76f8\u5173\u764c\u75c7<\/p>\n<\/section>\n

\n
\n
\n

\u5934\u9888\u90e8\u9cde\u72b6\u7ec6\u80de\u764c(HNSCC)\u3001\u80c3\u764c\u548c\u9ed8\u514b\u5c14\u7ec6\u80de\u764c(MCC)\u662f\u516c\u8ba4\u7684\u4e0e\u75c5\u6bd2\u611f\u67d3\u76f8\u5173\u7684\u75be\u75c5\uff0c\u5206\u522b\u662f\u7531\u4eba\u4e73\u5934\u7624\u75c5\u6bd2\u3001EB\u75c5\u6bd2\u548c\u9ed8\u514b\u5c14\u7ec6\u80de\u591a\u7624\u75c5\u6bd2\u5f15\u8d77\u7684\u3002\u5728\u8fd9\u4e9b\u80bf\u7624\u4e2d\uff0c\u75c5\u6bd2\u9633\u6027\u7684\u80bf\u7624\u7684PD-L1\u8868\u8fbe\u91cf\u6bd4\u75c5\u6bd2\u9634\u6027\u7684\u80bf\u7624\u66f4\u9ad8\u3002\u5982\u4eca\u8ba4\u4e3a\u75c5\u6bd2\u6297\u539f\u7684\u5b58\u5728\u6709\u52a9\u4e8e\u6297\u80bf\u7624\u514d\u75ab\u53cd\u5e94\uff0c\u56e0\u6b64\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u6ede\u5242\u53ef\u80fd\u5bf9\u8fd9\u4e9b\u80bf\u7624\u7684\u6cbb\u7597\u6709\u4e00\u5b9a\u7684\u6548\u679c\u3002\u521d\u6b65\u7814\u7a76\u8868\u660e\uff0c\u4e0e\u4e0a\u8ff0\u5176\u4ed6\u5b9e\u4f53\u80bf\u7624\u7c7b\u578b\u4e00\u6837\uff0c\u5982\u679cHSNCC\u60a3\u8005\u7684\u80bf\u7624\u662fPD-L1\u9633\u6027\uff0c\u5219\u6297PD-1\/PD-L1\u963b\u65ad\u6cbb\u7597\u6709\u6548\u7684\u53ef\u80fd\u6027\u66f4\u5927: PD–L1\u9633\u6027\u4e0e\u9634\u6027ORR\u5206\u522b\u4e3a21%\u5bf94%\u3002<\/p>\n

\u5728\u4e00\u9879\u4f7f\u7528\u6d3e\u59c6\u5355\u6297\u6cbb\u7597\u80c3\u764c\u60a3\u8005\u7684\u5c0f\u578b\u7814\u7a76\u4e2d\uff0c\u89c2\u5bdf\u5230\u7684ORR\u4e3a22%\u3002PD-L1\u8868\u8fbe\u91cf\u9700\u8981\u4ee51%\u4e3a\u9608\u503c\u8fdb\u884c\u767b\u8bb0\u9633\u6027\u548c\u9634\u6027; \u56e0\u6b64\uff0c\u672c\u7814\u7a76\u4e2d\u65e0\u6cd5\u6bd4\u8f83PD-L1(+)\u4e0e(-)\u4e4b\u95f4\u6f5c\u5728\u7684\u5dee\u5f02\u53cd\u5e94\uff0c\u672c\u7814\u7a76\u4e5f\u6ca1\u6709\u8bc4\u4f30EB\u75c5\u6bd2\u72b6\u6001\u3002<\/p>\n

\u5728\u4e00\u9879\u7814\u7a76\u4e2d\uff0cMCC\u60a3\u8005\u5bf9\u6297PD-1\u6297\u4f53\u7684\u6cbb\u7597\u53cd\u5e94\u4e0e\u75c5\u6bd2\u7684\u5b58\u5728\u6216PD-L1\u7684\u8868\u8fbe\u5e76\u4e0d\u663e\u8457\u76f8\u5173\u3002\u8fd9\u53ef\u80fd\u662f\u56e0\u4e3a\u75c5\u6bd2\u9634\u6027\u7684MCCs\u5177\u6709\u975e\u5e38\u9ad8\u7684\u7a81\u53d8\u5bc6\u5ea6\uff0c\u8fd9\u4e00\u7279\u5f81\u4e5f\u88ab\u8ba4\u4e3a\u662f\u6297PD-1\u7684\u53cd\u5e94\u7684\u751f\u7269\u6807\u5fd7\u7269(\u89c1\u4e0b\u9762\u7684\u7a81\u53d8\u8d1f\u8377\u90e8\u5206)\u3002\u75c5\u6bd2\u72b6\u6001\u548c\u5bf9\u514d\u75ab\u68c0\u67e5\u70b9\u963b\u65ad\u7684\u53cd\u5e94\u4e4b\u95f4\u7684\u5173\u7cfb\u662f\u4e00\u4e2a\u6b63\u5728\u79ef\u6781\u8fdb\u884c\u7814\u7a76\u7684\u9886\u57df\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n


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

\n
\n

23.3  PD-L1\u514d\u75ab\u7ec4\u5316\u68c0\u6d4b<\/strong><\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n

\u6700\u521d\u5173\u4e8ePD-L1\u8868\u8fbe\u4e0e\u6297PD-1\u53cd\u5e94\u76f8\u5173\u7684\u62a5\u9053\u662f\u901a\u8fc7\u5b9e\u9a8c\u5ba4\u884d\u751f\u7684IHC\u8bd5\u9a8c\u8fdb\u884c\u7684\u3002\u5f88\u5feb\u5728\u4e24\u4e2a\u4e0d\u540c\u7684\u514d\u75ab\u67d3\u8272\u5e73\u53f0\u4e0a\u5f00\u53d1\u4e86\u56db\u79cd\u4e0d\u540c\u7684\u4e13\u5229\u3001\u5546\u4e1aPD-L1\u68c0\u6d4b\u65b9\u6cd5\uff0c\u5e76\u8fdb\u884c\u4e86\u5404\u81ea\u516c\u53f8\u7684\u6297PD-1\/PD-L1\u8bd5\u5242\u7684\u4e34\u5e8a\u8bd5\u9a8c\uff0c\u89c1Table. 23.1<\/span>\u3002\u8bb8\u591a\u5206\u6790\u4f7f\u7528\u4e0d\u540c\u7684\u8bc4\u5206\u7cfb\u7edf\u548c\u4e0d\u540c\u7684\u9608\u503c\u6765\u533a\u5206PD-L1(+)\u4e0ePD-L1(\u2212)\u7684\u75c5\u4f8b\u3002\u9664\u4e86\u8ba9\u75c5\u7406\u5b66\u5bb6\u548c\u80bf\u7624\u5b66\u5bb6\u611f\u5230\u56f0\u60d1\u5916\uff0c\u8fd9\u79cd\u60c5\u51b5\u5bf9\u5916\u79d1\u75c5\u7406\u5b9e\u9a8c\u5ba4\u6765\u8bf4\u4e5f\u662f\u4e0d\u5207\u5b9e\u9645\u7684\uff0c\u56e0\u4e3a\u4ed6\u4eec\u4e0d\u592a\u53ef\u80fd\u6709\u5145\u8db3\u7684\u8d44\u6e90\u5728\u4e24\u4e2a\u4e0d\u540c\u7684\u514d\u75ab\u67d3\u8272\u5e73\u53f0\u4e0a\u652f\u6301\u56db\u79cd\u4e0d\u540c\u7684PD-L1\u68c0\u6d4b\u3002\u5927\u591a\u6570\u5b9e\u9a8c\u5ba4\u53ea\u6709\u4e00\u53f0\u514d\u75ab\u67d3\u8272\u4eea\uff0c\u800c\u4e14\u5b83\u4e0d\u4e00\u5b9a\u662f\u5e02\u573a\u4e0a\u7684\u68c0\u6d4b\u65b9\u6cd5\u6240\u8981\u6c42\u7684Dako Link 48\u6216Ventana BenchMark\u5e73\u53f0\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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


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

\n
\n

Table. 23.<\/span>1 <\/span>\u56db\u79cd\u4e0d\u540c\u7684\u5e02\u552ePD-L1\u514d\u75ab\u7ec4\u7ec7\u5316\u5b66\u68c0\u6d4b\u65b9\u6cd5<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n

FDA\u8ba4\u8bc6\u5230\u8fd9\u79cd\u201c\u4e00\u79cd\u68c0\u6d4b\/\u4e00\u79cd\u836f\u7269\u201d\u6a21\u5f0f\u7684\u6f5c\u5728\u5371\u9669\uff0c\u5e76\u652f\u6301\u6bd4\u8f83\u4e86\u56db\u79cd\u4e0d\u540c\u7684\u5e02\u552ePD-L1\u68c0\u6d4b\u65b9\u6cd5\u7684\u6027\u80fd\u3002\u6709\u56db\u5bb6\u638c\u63e1\u6297PD-1\/PD-L1\u7597\u6cd5\u7684\u516c\u53f8\u548c\u4e24\u5bb6\u751f\u4ea7PD-L1 \u514d\u75ab\u7ec4\u5316\u68c0\u6d4b\u5206\u6790\u7684\u516c\u53f8\u53c2\u4e0e\u4e86\u8fd9\u9879\u5de5\u4f5c\u3002\u5728\u8fd9\u9879\u88ab\u79f0\u4e3a\u201c\u84dd\u56fe\u5de5\u4f5c\u201d\u7684\u6700\u7ec8\u7814\u7a76\u4e2d\uff0c\u79d1\u5b66\u5bb6\u6536\u96c6\u4e8640\u4f8bNSCLC\u60a3\u8005\u7684\u5916\u79d1\u75c5\u7406\u75c5\u4f8b\uff0c\u5e76\u7528\u6bcf\u79cd\u68c0\u6d4b\u65b9\u6cd5\u5bf9\u8fde\u7eed\u7684FFPE\u80bf\u7624\u5207\u7247\u8fdb\u884c\u4e86\u67d3\u8272\u3002\u7136\u540e\uff0c\u4e09\u4f4d\u4e0d\u540c\u7684\u75c5\u7406\u5b66\u5bb6\u5bf9\u80bf\u7624\u7ec6\u80de\u548c\u514d\u75ab\u7ec6\u80dePD-L1\u7684\u8868\u8fbe\u8fdb\u884cPD-L1\u8bc4\u5206\uff0c\u53d6\u5176\u7ed3\u679c\u7684\u5e73\u5747\u503c\u3002\u91cd\u8981\u7684\u662f\uff0c\u5b83\u6ca1\u6709\u4f7f\u7528\u516c\u53f8\u5efa\u8bae\u7684\u8bc4\u5206\u7cfb\u7edf\u8fdb\u884c\u8bc4\u4f30\uff0c\u800c\u662f\u7b80\u5355\u5730\u4ee5\u80bf\u7624\u7ec6\u80de\u6216\u514d\u75ab\u7ec6\u80de\u67d3\u8272\u7684\u767e\u5206\u6bd4\u8fdb\u884c\u8bc4\u4f30\u3002\u4ed6\u4eec\u53d1\u73b0\u5176\u4e2d\u4e09\u79cd\u68c0\u6d4b\u65b9\u6cd5\u7684\u8868\u73b0\u975e\u5e38\u76f8\u4f3c\uff0822C3\u300128-8\u548cSP263\u68c0\u6d4b\u65b9\u6cd5\uff09\uff0c\u800cSP142\u68c0\u6d4b\u65b9\u6cd5\u660e\u663e\u6bd4\u5176\u4ed6\u4e09\u79cd\u68c0\u6d4b\u65b9\u6cd5\u6807\u8bb0\u51fa\u4e86\u66f4\u5c11\u7684\u80bf\u7624\u7ec6\u80de\u7684PD-L1\u8868\u8fbe\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n

\u8fd8\u6709\u4e24\u9879\u503c\u5f97\u6ce8\u610f\u7684\u7814\u7a76\u96c6\u4e2d\u5728\u68c0\u6d4b\u65b9\u6cd5\u7684\u6bd4\u8f83\u4e0a\u3002\u5176\u4e2d\u4e00\u9879\u7531\u767e\u65f6\u7f8e\u65bd\u8d35\u5b9d(Bristol-Myers Squibb)\u652f\u6301\u7684\u56fd\u5bb6\u7efc\u5408\u764c\u75c7\u7f51\u7edc(National Comprehensive Cancer Network)\u9886\u5bfc\uff0c\u670913\u540d\u5b66\u672f\u75c5\u7406\u5b66\u5bb6\u53c2\u4e0e\u3002\u8fd9\u9879\u5de5\u4f5c\u6bd4\u8f83\u4e8622C3\u68c0\u6d4b\u300128-8\u68c0\u6d4b\u3001\u4f7f\u7528SP142\u6297\u4f53\u514b\u9686\u7684\u5b9e\u9a8c\u5ba4\u884d\u751f\u68c0\u6d4b\uff08LDT\uff09\uff0c\u65e8\u5728\u6a21\u4effSP142\u5546\u4e1a\u68c0\u6d4b\uff0c\u4ee5\u53ca\u4f7f\u7528E1L3N\u514b\u9686\u7684LDT\uff0c\u5bf990\u4f8bNSCLC\u7684\u624b\u672f\u75c5\u7406\u6863\u6848\u8fdb\u884c\u4e86\u6bd4\u8f83\u3002\u5728\u8fd9\u9879\u89c4\u6a21\u8f83\u5927\u4e14\u6709\u7edf\u8ba1\u5b66\u4f9d\u636e\u7684\u7814\u7a76\u4e2d\uff0cSP142\u68c0\u6d4b\u65b9\u6cd5\u4e0d\u4ec5\u6807\u8bb0\u7684\u80bf\u7624\u7ec6\u80de\u67d3\u8272\u7684PD-L1\u8868\u8fbe\u8f83\u5c11\uff0c\u800c\u4e14\u514d\u75ab\u7ec6\u80de\u8868\u8fbe\u4e5f\u8f83\u5c11\u3002\u6709\u8da3\u7684\u662f\uff0c\u5728\u8fd9\u9879\u6bd4\u8f83\u4e2d\uff0c\u5f5313\u4f4d\u75c5\u7406\u5b66\u5bb6\u5bf9\u6bcf\u4e2a\u75c5\u4f8b\u8fdb\u884c\u5e73\u5747\u6253\u5206\u65f6\uff0c22C3\u68c0\u6d4b\u65b9\u6cd5\u6807\u8bb0\u7684\u80bf\u7624\u7ec6\u80de\u6bd428-8\u548cE1L3N\u68c0\u6d4b\u65b9\u6cd5\u7565\u5c11\u3002\u7136\u800c\uff0c\u4e2a\u522b\u75c5\u7406\u5b66\u5bb6\u4e4b\u95f4\u7684\u6253\u5206\u5dee\u5f02\u5927\u4e8e22C3\u68c0\u6d4b\u65b9\u6cd5\u4e0e28-8\u68c0\u6d4b\u65b9\u6cd5\u548cE1L3N LDT\u4e4b\u95f4\u89c2\u5bdf\u5230\u7684PD-L1\u6807\u8bb0\u7684\u5dee\u5f02\uff1b\u56e0\u6b64\uff0c\u5728\u5e38\u89c4\u5916\u79d1\u75c5\u7406\u5b9e\u8df5\u4e2d\uff0c\u8fd9\u79cd\u68c0\u6d4b\u6027\u80fd\u7684\u5dee\u5f02\u6c38\u8fdc\u4e0d\u4f1a\u88ab\u53d1\u73b0\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n

\u7b2c\u4e09\u9879\u5de5\u4f5c\u7814\u7a76\u4e86\u6570\u91cf\u6700\u591a\u7684\u75c5\u4f8b\u2014\u8fd1500\u4f8b\u5b58\u6863\u7684\u975e\u5c0f\u7ec6\u80de\u80ba\u764c\u75c5\u4f8b\u2014\u7531\u4e00\u540d\u75c5\u7406\u5b66\u5bb6\u6839\u636ePD-L1\u8868\u8fbe\u8fdb\u884c\u8bc4\u5206\u3002\u53e6\u4e00\u4f4d\u75c5\u7406\u5b66\u5bb6\u4e5f\u5bf9\u4e00\u90e8\u5206\u75c5\u4f8b\u8fdb\u884c\u4e86\u8bc4\u5206\u3002\u5728\u80bf\u7624\u7ec6\u80de\u67d3\u8272\u7684\u591a\u4e2a\u5207\u70b9\u4e0a\uff0c\u4ed6\u4eec\u663e\u793aSP263\u6cd5\u300128-8\u6cd5\u548c22C3\u6cd5\u7684\u4e00\u81f4\u6027>90%\u3002\u5728\u8fdb\u884c\u8fd9\u9879\u7814\u7a76\u65f6\uff0cSP142\u68c0\u6d4b\u8fd8\u6ca1\u6709\u5546\u4e1a\u5316\uff0c\u56e0\u6b64\u6ca1\u6709\u4e0e\u5176\u4ed6\u4e09\u79cd\u68c0\u6d4b\u65b9\u6cd5\u4e00\u8d77\u8fdb\u884c\u4e00\u81f4\u6027\u8bc4\u4f30\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n

\u5173\u4e8e\u5546\u4e1a\u4e0a\u53ef\u83b7\u5f97\u7684PD-L1\u68c0\u6d4b\u7684\u672f\u8bed\u53ef\u80fd\u4f1a\u4ee4\u4eba\u56f0\u60d1\uff0c\u56e0\u4e3a\u68c0\u6d4b\u672c\u8eab\u5305\u62ec\u514b\u9686\u540d\u79f0\u3002\u4f8b\u5982\uff0c\u201cSP142\u6297\u4f53\u514b\u9686\u201d\u4e0d\u540c\u4e8e\u201cSP142\u68c0\u6d4b\u201d\uff0cSP142\u68c0\u6d4b\u5305\u62ec\u8bb8\u591a\u8bd5\u5242\u7684\u96c6\u5408\u4f53\uff0c\u4e5f\u5305\u542bSP142\u6297\u4f53\u514b\u9686\uff0c\u8fd9\u4e9b\u8bd5\u5242\u4ee5\u7279\u5b9a\u7684\u987a\u5e8f\u5e76\u5728\u7cbe\u786e\u7684\u6280\u672f\u6761\u4ef6\u4e0b\u4f7f\u7528\uff0c\u4ee5\u5f62\u6210\u4e00\u4e2a\u68c0\u6d4b\u7cfb\u7edf\u3002\u56e0\u6b64\uff0cPD-L1\u514d\u75ab\u7ec4\u5316\u68c0\u6d4b\u4e2d\u89c2\u5bdf\u5230\u7684\u6027\u80fd\u5dee\u5f02\u53ef\u80fd\u662f\u7531\u4e00\u6297\u6d53\u5ea6\u3001\u6297\u4f53\u4eb2\u548c\u529b\u3001\u6297\u4f53\u9776\u5411\u7684\u8868\u4f4d\u3001\u6297\u539f\u68c0\u7d22\u8bd5\u5242\u3001\u7279\u5f02\u6027\u8bd5\u5242\u7684pH\u503c\u6216\u6269\u589e\u6b65\u9aa4\u7b49\u56e0\u7d20\u9020\u6210\u7684\u3002\u5546\u4e1a\u5316\u5316\u9a8c\u7684\u5316\u9a8c\u7cfb\u7edf\u662f\u4e13\u6709\u7684\uff1b\u6240\u4ee5\u5173\u4e8e\u6269\u5c55\u7684\u7ec4\u4ef6\u5217\u8868\u7684\u7ec6\u8282\u5f88\u5c11\u3002\u5df2\u7ecf\u8fdb\u884c\u4e86\u4e24\u9879\u4e0d\u540c\u7684\u7814\u7a76\uff0c\u4fdd\u6301\u5176\u4ed6\u68c0\u6d4b\u6761\u4ef6\u57fa\u672c\u4e0d\u53d8\uff0c\u4e13\u6ce8\u4e8e\u63a2\u7a76\u6297PD-L1\u6297\u4f53\u514b\u9686\u7684\u4e00\u81f4\u6027\u3002\u5bf9\u4e8e\u975e\u5c0f\u7ec6\u80de\u80ba\u764c\u6807\u672c\u548c\u9ed1\u8272\u7d20\u7624\u6807\u672c\uff0c\u5f53\u6240\u6709\u5176\u4ed6\u68c0\u6d4b\u6761\u4ef6\u4fdd\u6301\u4e0d\u53d8\u65f6\uff0cSP142\u6297\u4f53\u7684\u8868\u73b0\u4e0e28-8\u300122C3\u548cSP263\u514b\u9686\u7684\u6297\u4f53\u4e00\u6837\u597d\u3002\u5f53\u89c2\u5bdf\u5230\u6297\u4f53\u514b\u9686\u4e4b\u95f4\u7684\u5dee\u5f02\u65f6\uff0c\u5bf9\u5207\u7247\u7684\u5ba1\u67e5\u8868\u660e\uff0c\u8fd9\u4e9b\u5dee\u5f02\u662f\u7531\u4e8ePD-L1\u8868\u8fbe\u7684\u5c40\u57df\u6027\u548c\u5f02\u8d28\u6027\uff0c\u5728\u4e0d\u540c\u7684\u80bf\u7624\u5207\u7247\u4e0a\u6709\u6240\u4e0d\u540c\uff0c\u800c\u4e0d\u662f\u5728\u80bf\u7624\u7ec6\u80de\u6216\u514d\u75ab\u7ec6\u80de\u6807\u8bb0\u7684\u68c0\u6d4b\u7075\u654f\u5ea6\u4e0a\u6709\u660e\u663e\u7684\u5dee\u5f02\u3002\u6807\u8bb0PD-L1\u5206\u5b50\u7684\u80de\u5185\u533a\u6216\u80de\u5916\u533a\u7684\u6297\u4f53\u5bf9\u4e00\u81f4\u6027\u6ca1\u6709\u663e\u8457\u5f71\u54cd\uff0cFig. 23.2<\/span>\u3002\u56e0\u6b64\uff0c\u8fd9\u4e9b\u7814\u7a76\u8868\u660e\uff0c\u4e0e\u5176\u4ed6\u5546\u4e1a\u68c0\u6d4b\u65b9\u6cd5\u76f8\u6bd4\uff0cSP142\u6297\u4f53\u514b\u9686\u672c\u8eab\u4ee5\u5916\u7684\u68c0\u6d4b\u7cfb\u7edf\u7684\u67d0\u4e9b\u5176\u4ed6\u7ec4\u4ef6\u5bfc\u81f4\u4e86\u89c2\u5bdf\u5230\u7684SP142\u68c0\u6d4b\u6027\u80fd\u7684\u5dee\u5f02\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n

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


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

\n
\n

Fig. 23.2 <\/span>\u5546\u7528PD-L1\u6297\u4f53\u542b\u6709\u4e0d\u540c\u7684\u4e00\u6297\uff0c\u5176\u4e2d\u4e00\u4e9b\u9488\u5bf9PD-L1\u5206\u5b50\u7684\u80de\u5916\u533a(22C3\u548c28-8)\uff0c\u800c\u53e6\u4e00\u4e9b\u9488\u5bf9\u80de\u5185\u533a(SP142\u548cSP263)<\/p>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n

\u7efc\u4e0a\u6240\u8ff0\uff0c\u8fd9\u4e9b\u5171\u540c\u53d1\u73b0\u8868\u660e\uff0c\u5728\u672a\u6765\uff0c\u5916\u79d1\u75c5\u7406\u5b9e\u9a8c\u5ba4\u53ef\u80fd\u53ea\u80fd\u63d0\u4f9b\u4e09\u79cd\u5177\u6709\u7c7b\u4f3c\u6027\u80fd\u7684\u5546\u4e1aPD-L1\u6d4b\u5b9a\u65b9\u6cd5(28-8\u300122C3\u6216SP263\u6d4b\u5b9a)\u4e2d\u7684\u4e00\u79cd\uff0c\u6216\u63d0\u4f9b\u5177\u6709\u540c\u7b49\u6027\u80fd\u7279\u5f81\u7684LDT(\u5305\u62ec\u4f7f\u7528SP142\u514b\u9686\u7684\u65b9\u6cd5)\uff0c\u6216\u8005\u5176\u4ed6\u7684\u7279\u5f02\u6027\u7684\uff0c\u5546\u4e1a\u5316\u8bbe\u8ba1\u5e76\u7ecf\u8fc7\u4e34\u5e8a\u6d4b\u8bd5\u7684PD-L1\u8868\u8fbe\u8bc4\u5206\u7cfb\u7edf\u5e76\u4e0e\u9002\u5f53\u7684\u6297PD -1\/PD-L1\u6cbb\u7597\u836f\u7269\u5339\u914d\u3002\u7531\u4e8ePD-L1\u8868\u8fbe\u7684\u5c40\u7076\u6027\uff0c\u4ee5\u53ca\u5bc6\u5207\u76f8\u5173\u7684\u65f6\u95f4\u548c\u7a7a\u95f4\u5f02\u8d28\u6027\u95ee\u9898\uff0c\u9700\u8981\u8fdb\u884c\u989d\u5916\u7684\u7814\u7a76\u6765\u786e\u5b9a\u7406\u60f3\u7684\u7ec4\u7ec7\u7c7b\u578b(\u6807\u672c\u5927\u5c0f\u548c\u75c5\u53d8\u6570\u91cf\u7b49)\uff0c\u4ee5\u4f18\u5316PD-L1\u5728\u6cbb\u7597\u524d\u80bf\u7624\u5fae\u73af\u5883\u4e2d\u8868\u8fbe\u7684\u9884\u6d4b\u4ef7\u503c\u3002<\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n
\n

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


<\/p>\n

\u2014 THE  END \u2014<\/span><\/p>\n


<\/p>\n

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

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

\u4f5c\u8005 | <\/span>Nicolas A. Giraldo and Janis M. Taube<\/span><\/span><\/p>\n

\u521d\u7a3f\u7ffb\u8bd1 | \u7f57\u4f73\u4f73 \u7ae0\u9707<\/span><\/span><\/span><\/p>\n

\u7f16\u8f91\u6392\u7248<\/span> | \u675c\u8f7b\u677e<\/span><\/span><\/p>\n

\u5ba1\u6838\u4fee\u6539 | \u738b\u5764 \u80e1\u73ca<\/span><\/p>\n

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


<\/p>\n

\u2589  \u5f80\u671f\u63a8\u9001\u5408\u8f91<\/strong><\/strong><\/section>\n
\n
\n
\n
\n
\n
\n
\n
\n
\n
<\/strong><\/strong><\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n
\n
\n
\n
\n
\n
\n
\n
\n
\n
\n
\n
\n
\n

\u80bf\u7624\u514d\u75ab\u5b66\u6700\u65b0\u6587\u732e<\/span><\/a>
<\/p>\n

\u514d\u75ab\u5b66\u62fe\u9057\u7cfb\u5217<\/a><\/span><\/p>\n

\u80bf\u7624\u514d\u75ab\u5b66\u7cfb\u5217<\/span><\/a><\/p>\n

ACIR\u6587\u732e\u901f\u9012<\/span><\/a><\/p>\n

SCI\u8bba\u6587\u4f5c\u56fe<\/span><\/a><\/p>\n

SCI\u8bba\u6587\u5199\u4f5c\u53ca\u6295\u7a3f<\/span><\/a><\/p>\n

\u751f\u4fe1\u5165\u95e8\u5b66\u4e60\u7b14\u8bb0<\/span><\/a><\/p>\n

R\u8bed\u8a00\u57fa\u7840\u4e0e\u5355\u7ec6\u80de\u5206\u6790\u5b9e\u6218\u89c6\u9891\u8bfe\u7a0b<\/span><\/a><\/p>\n

\u751f\u7269\u5b66\u5b9e\u9a8c\u6280\u672f\u53ca\u5e38\u7528\u8f6f\u4ef6<\/span><\/a><\/p>\n

RCIM\u4eea\u5668\u7b80\u4ecb\u53ca\u64cd\u4f5c\u89c6\u9891<\/a><\/span><\/p>\n

\u5e38\u7528\u7535\u8111\u8f6f\u4ef6\u4f7f\u7528\u6559\u7a0b<\/a><\/span><\/p>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n<\/section>\n

\n
\n
\n
\n
\n
\n
\n
\n
\n


<\/p>\n

<\/span><\/p>\n

\u5173\u6ce8\u672c\u53f7~<\/span>
<\/p>\n


<\/p>\n

<\/p>\n

\u52a0\u5165\u8bfb\u8005\u4ea4\u6d41\u7fa4~<\/span><\/p>\n

\uff08\u6dfb\u52a0\u8bf7\u5907\u6ce8\u5355\u4f4d\u59d3\u540d\uff09<\/span><\/p>\n


<\/p>\n

<\/p>\n

\u52a0\u5165\u77e5\u8bc6\u661f\u7403~<\/span><\/p>\n


<\/p>\n


<\/p>\n


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

\u70b9\u4eae\u8d5e\u4e0e\u5728\u770b <\/span><\/p>\n

\u8ba9\u66f4\u591a\u4eba\u770b\u5230<\/span><\/p>\n

<\/mp-style-type><\/p>\n

\n

\u672c\u7bc7\u6587\u7ae0\u6765\u6e90\u4e8e\u5fae\u4fe1\u516c\u4f17\u53f7: OncoLab <\/p>\n<\/blockquote>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

23.1 \u5f15\u8a00 \u968f\u7740\u514d\u75ab\u7597\u6cd5\u52a0\u5165\u4e3b\u6d41\u764c\u75c7\u6cbb\u7597\u624b\u6bb5\u7684\u884c\u5217\uff0c\u4eba\u4eec\u4fbf\u5f00\u59cb\u5173\u6ce8\u4e0e\u53cd\u5e94\u6027\u548c\u8010\u836f\u6027\u6709\u5173\u7684\u751f\u7269\u6807\u8bb0\u7269\u3002\u6cbb\u7597\u524d…<\/p>\n","protected":false},"author":1,"featured_media":3189,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[65],"tags":[],"_links":{"self":[{"href":"http:\/\/oncolab.cn\/index.php\/wp-json\/wp\/v2\/posts\/3193"}],"collection":[{"href":"http:\/\/oncolab.cn\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/oncolab.cn\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/oncolab.cn\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/oncolab.cn\/index.php\/wp-json\/wp\/v2\/comments?post=3193"}],"version-history":[{"count":0,"href":"http:\/\/oncolab.cn\/index.php\/wp-json\/wp\/v2\/posts\/3193\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/oncolab.cn\/index.php\/wp-json\/wp\/v2\/media\/3189"}],"wp:attachment":[{"href":"http:\/\/oncolab.cn\/index.php\/wp-json\/wp\/v2\/media?parent=3193"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/oncolab.cn\/index.php\/wp-json\/wp\/v2\/categories?post=3193"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/oncolab.cn\/index.php\/wp-json\/wp\/v2\/tags?post=3193"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}