{"id":2712,"date":"2024-01-17T08:00:00","date_gmt":"2024-01-17T00:00:00","guid":{"rendered":"\/\/www.yitiaoweiba.com\/?p=2712"},"modified":"2024-02-18T16:55:56","modified_gmt":"2024-02-18T08:55:56","slug":"%e5%85%a9%e5%ba%a6%e7%99%bb%e9%a0%82jama%e4%b8%bb%e5%88%8a%ef%bc%81%e5%90%9b%e5%af%a6%e7%94%9f%e7%89%a9%e7%89%b9%e7%91%9e%e6%99%ae%e5%88%a9%e5%96%ae%e6%8a%97%e5%bb%ba%e7%ab%8b%e8%82%ba%e7%99%8c","status":"publish","type":"post","link":"\/\/www.yitiaoweiba.com\/zh-hant\/%e5%85%a9%e5%ba%a6%e7%99%bb%e9%a0%82jama%e4%b8%bb%e5%88%8a%ef%bc%81%e5%90%9b%e5%af%a6%e7%94%9f%e7%89%a9%e7%89%b9%e7%91%9e%e6%99%ae%e5%88%a9%e5%96%ae%e6%8a%97%e5%bb%ba%e7%ab%8b%e8%82%ba%e7%99%8c\/","title":{"rendered":"\u5169\u5ea6\u767b\u9802JAMA\u4e3b\u520a\uff01\u541b\u5be6\u751f\u7269\u7279\u745e\u666e\u5229\u55ae\u6297\u5efa\u7acb\u80ba\u764c\u570d\u624b\u8853\u671f\u6cbb\u7642\u65b0\u6a21\u5f0f"},"content":{"rendered":"\n<p>\u7576\u5730\u6642\u95932024\u5e741\u670816\u65e5\uff0c\u7531\u4e0a\u6d77\u4ea4\u901a\u5927\u5b78\u91ab\u5b78\u9662\u9644\u5c6c\u80f8\u79d1\u91ab\u9662\u9678\u821c\u6559\u6388\u727d\u982d\u958b\u5c55\u7684\u7279\u745e\u666e\u5229\u55ae\u6297\u806f\u5408\u5316\u7642\u7528\u65bc\u53ef\u5207\u9664\u975e\u5c0f\u7d30\u80de\u80ba\u764c\uff08NSCLC\uff09\u570d\u624b\u8853\u671f\u6cbb\u7642\u7684\u2162\u671f\u7814\u7a76\uff08NEOTORCH\uff09\u7372\u570b\u969b\u9802\u5c16\u6b0a\u5a01\u671f\u520a\u300a\u7f8e\u570b\u91ab\u5b78\u6703\u96dc\u8a8c\u300b\uff08<em>Journal of the American Medical Association<\/em>\uff0c<em>JAMA<\/em>\uff0c\u5f71\u97ff\u56e0\u6578\uff1a120.7\uff09\u767c\u8868\uff0c\u6210\u70ba<strong>\u5168\u7403\u9996\u500b\u767b\u9802JAMA\u4e3b\u520a\u7684\u80ba\u764c\u570d\u624b\u8853\u671f\uff08\u6db5\u84cb\u65b0\u8f14\u52a9\u548c\u8f14\u52a9\uff09\u514d\u75ab\u6cbb\u7642\u7814\u7a76<\/strong>\uff0c\u6a39\u7acb\u80ba\u764c\u570d\u624b\u8853\u671f\u6cbb\u7642\u65b0\u6a19\u6746\u3002\u672c\u6587\u7684\u901a\u8a0a\u4f5c\u8005\u662f\u9678\u821c\u6559\u6388\uff0c\u5171\u540c\u7b2c\u4e00\u4f5c\u8005\u662f\u9678\u821c\u6559\u6388\uff0c\u5357\u660c\u5927\u5b78\u7b2c\u4e00\u9644\u5c6c\u91ab\u9662\u5f35\u5049\u6559\u6388\uff0c\u6e56\u5357\u7701\u816b\u7624\u91ab\u9662\u9114\u9e9f\u6559\u6388\u3001\u738b\u6587\u7965\u6559\u6388\uff0c\u4ee5\u53ca\u540c\u6fdf\u5927\u5b78\u9644\u5c6c\u4e0a\u6d77\u5e02\u80ba\u79d1\u91ab\u9662\u5f35\u9d6c\u6559\u6388\u3002<\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"865\" height=\"294\" src=\"\/\/www.yitiaoweiba.com\/wp-content\/uploads\/2024\/02\/image.png\" alt=\"\" class=\"wp-image-2713\"\/><figcaption class=\"wp-element-caption\">\u4f86\u6e90\uff1a<em>JAMA<\/em>\u5b98\u7db2<\/figcaption><\/figure>\n\n\n\n<p>NEOTORCH\u7814\u7a76\uff08NCT04158440\uff09\u662f\u4e00\u9805\u96a8\u6a5f\u3001\u96d9\u76f2\u3001\u5b89\u6170\u5291\u5c0d\u7167\u7684\u2162\u671f\u81e8\u5e8a\u7814\u7a76\uff0c\u65e8\u5728\u6bd4\u8f03\u7279\u745e\u666e\u5229\u55ae\u6297\u6216\u5b89\u6170\u5291\u806f\u5408\u5316\u7642\u7528\u65bc\u53ef\u5207\u9664\u2161-\u2162\u671fNSCLC\u60a3\u8005\u570d\u624b\u8853\u671f\u6cbb\u7642\u7684\u7642\u6548\u548c\u5b89\u5168\u6027\u3002\u4f5c\u70ba<strong>\u5168\u7403\u9996\u500b<\/strong>\u6297PD-1\u55ae\u6297\u7528\u65bcNSCLC\u570d\u624b\u8853\u671f\uff08\u6db5\u84cb\u65b0\u8f14\u52a9\u548c\u8f14\u52a9\u6cbb\u7642\uff09\u6cbb\u7642\u9054\u5230\u7121\u4e8b\u4ef6\u751f\u5b58\u671f\uff08EFS\uff09\u967d\u6027\u7d50\u679c\u7684\u2162\u671f\u81e8\u5e8a\u7814\u7a76\uff0cNEOTORCH\u57282023\u5e74\u7f8e\u570b\u81e8\u5e8a\u816b\u7624\u5b78\u6703\uff08ASCO\uff09\u5168\u9ad4\u5927\u6703\u7cfb\u52174\u6708\u6703\u8b70\u4ee5\u53caASCO\u5e74\u6703\u4e0a\u516c\u4f48\u4e86\u2162\u671fNSCLC\u60a3\u8005\u7684EFS\u671f\u4e2d\u5206\u6790\u7d50\u679c\uff0c\u7372\u5f97\u570b\u969b\u5b78\u8005\u7684\u5ee3\u6cdb\u95dc\u6ce8\u3002\u6b64\u6b21\u518d\u7372\u5168\u7403\u6392\u540dTOP4\u7684SCI\u5b78\u8853\u671f\u520aJAMA\u767c\u8868\uff0c\u4e5f\u8b93<strong>\u7279\u745e\u666e\u5229\u55ae\u6297\u6210\u70ba\u9996\u500b\u5169\u5ea6\u767b\u9802JAMA\u4e3b\u520a\u7684\u570b\u7522PD-(L)1\u6291\u5236\u5291<\/strong>\u3002<\/p>\n\n\n\n<p><strong>NEOTORCH\u7814\u7a76\u4e3b\u8981\u7814\u7a76\u8005\u9678\u821c\u6559\u6388<\/strong>\u8868\u793a\uff1a\u201c\u4e0d\u8ad6\u662f\u81e8\u5e8a\u8a3a\u7642\u6c34\u6e96\u9084\u662f\u81e8\u5e8a\u79d1\u7814\u80fd\u529b\uff0c\u6211\u5011\u5df2\u7d93\u7531\u6b64\u524d\u7684\u2018\u8ddf\u8dd1\u8005\u2019\u9010\u6f38\u8f49\u8b8a\u70ba\u2018\u540c\u884c\u8005\u2019\u751a\u81f3\u5728\u4e00\u4e9b\u65b9\u9762\u6210\u70ba\u2018\u9818\u8dd1\u8005\u2019\u3002\u8d8a\u4f86\u8d8a\u591a\u7684\u4e2d\u570b\u5275\u65b0\u65b9\u6848\u7d2e\u6839\u4e2d\u570b\uff0c\u8d70\u5411\u4e16\u754c\uff0c\u4e26\u6700\u7d42\u6539\u8b8a\u5168\u7403\u6cbb\u7642\u6a19\u6e96\u3002\u6b64\u6b21NEOTORCH\u7372\u5f97JAMA\u767c\u8868\u662f\u4e00\u500b\u8d77\u9ede\uff0c\u4e2d\u570b\u539f\u5275\u7684\u20183+1+13\u2019\u570d\u8853\u671f\u6cbb\u7642\u6a21\u5f0f\u5177\u6709\u6700\u9ad8\u5faa\u8b49\u91ab\u5b78\u50f9\u503c\uff0c\u5fc5\u5c07\u70ba\u60a3\u8005\u5efa\u7acb\u65b0\u7684\u6cbb\u7642\u6a19\u6e96\uff0c\u70ba\u4e2d\u570b\u4e43\u81f3\u5168\u7403\u80ba\u764c\u8a3a\u7642\u683c\u5c40\u5e36\u4f86\u8b8a\u9769\u3002\u201d<\/p>\n\n\n\n<p>\u4f5c\u70ba\u76ee\u524d\u7d0d\u5165<strong>\u4e2d\u570b\u6700\u5927\u6a23\u672c<\/strong>\u53ef\u5207\u9664\u2162\u671fNSCLC\u60a3\u8005\u7684\u570d\u624b\u8853\u671f\u524d\u77bb\u6027\u2162\u671f\u81e8\u5e8a\u7814\u7a76\uff0cNEOTORCH\u5171\u7d0d\u5165404\u4f8b\u2162\u671fNSCLC\u60a3\u8005\uff08\u7279\u745e\u666e\u5229\u55ae\u6297\u806f\u5408\u5316\u7642\u7d44202\u4f8b\uff0c\u5b89\u6170\u5291\u806f\u5408\u5316\u7642\u7d44202\u4f8b\uff09\uff0c\u4ee51:1\u7684\u6bd4\u4f8b\u96a8\u6a5f\u63a5\u53d7\u7279\u745e\u666e\u5229\u55ae\u6297\u6216\u5b89\u6170\u5291\u806f\u5408\u5316\u7642\u8853\u524d3\u9031\u671f\u53ca\u8853\u5f8c1\u9031\u671f\u570d\u624b\u8853\u6cbb\u7642\uff0c\u96a8\u5f8c\u63a5\u53d7\u7279\u745e\u666e\u5229\u55ae\u6297\u6216\u5b89\u6170\u5291\u978f\u56fa\u6cbb\u764213\u9031\u671f\uff08\u5373\uff1a\u201c3+1+13\u201d\u6cbb\u7642\u6a21\u5f0f\uff09\u3002<\/p>\n\n\n\n<p>\u622a\u81f32022\u5e7411\u670830\u65e5\uff08\u4e2d\u4f4d\u96a8\u8a2a18.3\u500b\u6708\uff09\uff0c\u7814\u7a76\u7d50\u679c\u986f\u793a\uff0c\u8207\u55ae\u7368\u5316\u7642\u76f8\u6bd4\uff0c\u7279\u745e\u666e\u5229\u55ae\u6297\u806f\u5408\u5316\u7642\u570d\u624b\u8853\u671f\u6cbb\u7642\u5f8c\u7279\u745e\u666e\u5229\u55ae\u6297\u55ae\u85e5\u978f\u56fa\u6cbb\u7642\uff0c\u53ef\u986f\u8457\u5ef6\u9577\u53ef\u5207\u9664\u2162\u671fNSCLC\u60a3\u8005\u7684EFS\uff0c\u660e\u986f\u63d0\u9ad8\u4e3b\u8981\u75c5\u7406\u7de9\u89e3\uff08MPR\uff09\u548c\u5b8c\u5168\u75c5\u7406\u7de9\u89e3\uff08pCR\uff09\u7387\u3002\u7121\u8ad6\u816b\u7624\u5206\u671f\uff08\u2162A\u671f\u6216\u2162B\u671f\uff09\u3001\u7d44\u7e54\u4e9e\u578b\uff08\u9c57\u764c\u6216\u975e\u9c57\u764c\uff09\u53caPD-L1\u8868\u9054\u5982\u4f55\uff0cEFS\u5747\u53ef\u7372\u76ca\uff0c\u540c\u6642OS\u4e5f\u986f\u793a\u51fa\u660e\u986f\u7684\u7372\u76ca\u8da8\u52e2\uff0c\u5b89\u5168\u6027\u53ef\u9810\u671f\u3001\u53ef\u7ba1\u7406\u3002<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u8207\u55ae\u7d14\u5316\u7642\u76f8\u6bd4\uff0c\u7279\u745e\u666e\u5229\u55ae\u6297\u806f\u5408\u5316\u7642\u986f\u8457\u5ef6\u9577\u60a3\u8005\u7684EFS\uff08\u7814\u7a76\u8005\u8a55\u4f30\u7684\u4e2d\u4f4dEFS\u70ba\uff1a\u5c1a\u672a\u6210\u719f vs. 15.1\u500b\u6708\uff09\uff0c\u5c07\u75be\u75c5\u5fa9\u767c\u3001\u9032\u5c55\u6216\u6b7b\u4ea1\u98a8\u96aa\u964d\u4f4e60%\uff08HR=0.40\uff1b95%CI\uff1a0.28-0.57)\uff0c\u96d9\u5074P&lt;0.001\u3002<\/li>\n\n\n\n<li>\u7279\u745e\u666e\u5229\u55ae\u6297\u806f\u5408\u5316\u7642\u7d44\u7684MPR\u7387\u660e\u986f\u66f4\u512a\uff0c\u662f\u5b89\u6170\u5291\u806f\u5408\u5316\u7642\u7d44\u76846\u500d\uff08\u76f2\u614b\u7368\u7acb\u4e2d\u5fc3\u75c5\u7406[BIPR]\u8a55\u4f30\u7684MPR\u7387\u5206\u5225\u70ba48.5% vs. 8.4%\uff09\u3002\u540c\u6642\uff0c\u7279\u745e\u666e\u5229\u55ae\u6297\u806f\u5408\u5316\u7642\u7d44\u7684pCR\u7387\u4e5f\u8f03\u5b89\u6170\u5291\u806f\u5408\u5316\u7642\u7d44\u63d0\u9ad8\u4e8625\u500d\uff08BIPR\u8a55\u4f30\u7684pCR\u7387\u5206\u5225\u70ba24.8% vs. 1.0%\uff09\u3002<\/li>\n\n\n\n<li>\u7279\u745e\u666e\u5229\u55ae\u6297\u806f\u5408\u5316\u7642\u986f\u8457\u6539\u5584\u60a3\u8005\u7684\u7121\u75c5\u751f\u5b58\u671f\uff08DFS\uff09\uff0c\u5c07\u75be\u75c5\u5fa9\u767c\u6216\u6b7b\u4ea1\u98a8\u96aa\u964d\u4f4e50%\uff08HR=0.50\uff1b95%CI: 0.33-0.76\uff09\uff0c\u4e26\u4e14\u7279\u745e\u666e\u5229\u55ae\u6297\u7d44\u6709\u660e\u986f\u7684OS\u7372\u76ca\u8da8\u52e2\uff08\u4e2d\u4f4dOS\u5206\u5225\u70ba\uff1a\u5c1a\u672a\u9054\u5230 vs. 30.4\u500b\u6708\uff0cHR=0.62[95% CI: 0.38-1.00]\uff09\u3002<\/li>\n\n\n\n<li>\u806f\u5408\u7279\u745e\u666e\u5229\u55ae\u6297\u5f8c\u7684\u65b0\u8f14\u52a9\u6cbb\u7642\u70ba\u66f4\u591a\u60a3\u8005\u5e36\u4f86\u4e86\u6839\u6cbb\u6027\u624b\u8853\u5207\u9664\u7684\u6a5f\u6703\uff0c\u624b\u8853\u5207\u9664\u7387\u5206\u5225\u70ba82.2% vs. 73.3%\uff0c\u5176\u4e2d\u7279\u745e\u666e\u5229\u55ae\u6297\u7d44\u670995.8%\u7684\u60a3\u8005\u5be6\u73feR0\u5207\u9664\u3002<\/li>\n\n\n\n<li>\u5169\u7d44\u6cbb\u7642\u671f\u9593\u51fa\u73fe\u7684\u4e0d\u826f\u4e8b\u4ef6\uff08TEAE\uff09\u767c\u751f\u7387\u76f8\u4f3c\uff0c\u672a\u767c\u73fe\u65b0\u7684\u5b89\u5168\u6027\u4fe1\u865f\u3002<\/li>\n<\/ul>\n\n\n\n<p>\u57fa\u65bcNEOTORCH\u53d6\u5f97\u7684\u5353\u8d8a\u6210\u679c\uff0c2023\u5e7412\u6708\uff0c\u570b\u5bb6\u85e5\u54c1\u76e3\u7763\u7ba1\u7406\u5c40\uff08NMPA\uff09\u6b63\u5f0f\u6279\u51c6\u7279\u745e\u666e\u5229\u55ae\u6297\u806f\u5408\u5316\u7642\u570d\u624b\u8853\u671f\u6cbb\u7642\uff0c\u7e7c\u4e4b\u7279\u745e\u666e\u5229\u55ae\u6297\u55ae\u85e5\u4f5c\u70ba\u8f14\u52a9\u6cbb\u7642\uff0c\u7528\u65bc\u53ef\u5207\u9664IIIA-IIIB\u671fNSCLC\u7684\u6210\u4eba\u60a3\u8005\uff0c\u6210\u70ba\u6211\u570b\u9996\u500b\u7372\u6279\u7684\u80ba\u764c\u570d\u624b\u8853\u671f\u7642\u6cd5\u3002<\/p>\n\n\n\n<p><strong>\u541b\u5be6\u751f\u7269\u7e3d\u7d93\u7406\u517c\u9996\u5e2d\u57f7\u884c\u5b98\u9112\u5efa\u8ecd\u535a\u58eb<\/strong>\u8868\u793a\uff1a\u201c\u6b64\u6b21NEOTORCH\u7684\u91cd\u8981\u7814\u7a76\u6210\u679c\u7372\u5f97JAMA\u767c\u8868\uff0c\u9ad4\u73fe\u4e86\u570b\u969b\u5b78\u8853\u754c\u5c0d\u7279\u745e\u666e\u5229\u55ae\u6297\u53ca\u5168\u7403\u9996\u5275\u7684\u20183+1+13\u2019\u80ba\u764c\u570d\u624b\u8853\u671f\u514d\u75ab\u6cbb\u7642\u6a21\u5f0f\u7684\u9ad8\u5ea6\u8a8d\u53ef\u3002\u6211\u5011\u671f\u5f85\uff0c\u7279\u745e\u666e\u5229\u55ae\u6297\u80fd\u5920\u5f15\u9818\u6211\u570b\u80ba\u764c\u570d\u624b\u8853\u671f\u6cbb\u7642\u9032\u5165\u514d\u75ab\u65b0\u6642\u4ee3\uff0c\u63a8\u52d5\u816b\u7624\u6cbb\u7642\u7684\u2018\u6162\u75c5\u5316\u2019\u9032\u7a0b\u3002\u541b\u5be6\u751f\u7269\u4e5f\u5c07\u6301\u7e8c\u5275\u65b0\uff0c\u70ba\u60a3\u8005\u5e36\u4f86\u66f4\u591a\u66f4\u597d\u7684\u5275\u65b0\u7642\u6cd5\u9078\u64c7\uff01\u201d<\/p>\n\n\n\n<p><\/p>\n\n\n\n<h5 class=\"wp-block-heading\">\u3010\u53c3\u8003\u6587\u737b\u3011<\/h5>\n\n\n\n<h5 class=\"wp-block-heading\">1. Lu S, Zhang W, et al. Perioperative Toripalimab Plus Chemotherapy for Patients With Resectable Non-Small Cell Lung Cancer: The Neotorch Randomized Clinical Trial. JAMA. 2024 Jan 16;331(3):201-211.<\/h5>\n\n\n\n<p><\/p>\n\n\n\n<h6 class=\"wp-block-heading\"><em>1. <em>\u672c\u6750\u6599\u65e8\u5728\u50b3\u905e\u524d\u6cbf\u8cc7\u8a0a\uff0c\u7121\u610f\u5411\u60a8\u505a\u4efb\u4f55\u7522\u54c1\u7684\u63a8\u5ee3\uff0c\u4e0d\u4f5c\u70ba\u81e8\u5e8a\u7528\u85e5\u6307\u5c0e\u3002<\/em><\/em><\/h6>\n\n\n\n<h6 class=\"wp-block-heading\"><em>2. <\/em>\u82e5\u60a8\u60f3\u77ad\u89e3\u5177\u9ad4\u75be\u75c5\u8a3a\u7642\u8cc7\u8a0a\uff0c\u8acb\u9075\u5f9e\u91ab\u7642\u885b\u751f\u5c08\u696d\u4eba\u58eb\u7684\u610f\u898b\u8207\u6307\u5c0e\u3002<\/h6>\n\n\n\n<p><\/p>\n\n\n\n<p><strong>\u95dc\u65bcNEOTORCH\u7814\u7a76<\/strong><\/p>\n\n\n\n<p>NEOTORCH\u7814\u7a76\uff08NCT04158440\uff09\u662f\u4e00\u9805\u96a8\u6a5f\u3001\u96d9\u76f2\u3001\u5b89\u6170\u5291\u5c0d\u7167\u7684\u2162\u671f\u81e8\u5e8a\u7814\u7a76\uff0c\u65e8\u5728\u6bd4\u8f03\u7279\u745e\u666e\u5229\u55ae\u6297\u6216\u5b89\u6170\u5291\u806f\u5408\u5316\u7642\u7528\u65bc\u53ef\u5207\u9664\u2161-\u2162\u671fNSCLC\u60a3\u8005\u570d\u624b\u8853\u671f\u6cbb\u7642\u7684\u7642\u6548\u548c\u5b89\u5168\u6027\u3002\u7814\u7a76\u5171\u7d0d\u5165501\u4f8b\u2161-\u2162\u671fNSCLC\u60a3\u8005\uff0c\u4ee51:1\u7684\u6bd4\u4f8b\u96a8\u6a5f\u63a5\u53d7\u7279\u745e\u666e\u5229\u55ae\u6297\uff08240mg\uff09\u6216\u5b89\u6170\u5291\u806f\u5408\u5316\u7642\u8853\u524d3\u9031\u671f\u53ca\u8853\u5f8c1\u9031\u671f\u570d\u624b\u8853\u6cbb\u7642\uff08\u9c57\u764c\u60a3\u8005\u5316\u7642\u65b9\u6848\u70ba\u7d2b\u6749\u985e+\u9251\u985e\uff0c\u975e\u9c57\u764c\u60a3\u8005\u5316\u7642\u65b9\u6848\u70ba\u57f9\u7f8e\u66f2\u585e+\u9251\u985e\uff09\uff0c\u96a8\u5f8c\u63a5\u53d7\u7279\u745e\u666e\u5229\u55ae\u6297\uff08240mg\uff09\u6216\u5b89\u6170\u5291\u978f\u56fa\u6cbb\u764213\u9031\u671f\u3002\u7814\u7a76\u6309\u7167\u75be\u75c5\u5206\u671f\uff08\u2161\u671f vs. \u2162A\u671f vs. \u2162B\u671f\uff09\u3001PD-L1\u8868\u9054\u72c0\u614b\uff08\u22651% vs. &lt;1%\u6216\u7121\u6cd5\u8a55\u4f30\uff09\u3001\u64ec\u624b\u8853\u65b9\u5f0f\uff08\u5168\u80ba\u5207\u9664\u8853 vs. \u80ba\u8449\u5207\u9664\u8853\uff09\u548c\u7d44\u7e54\u5b78\u5206\u578b\uff08\u9c57\u764c vs. 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