Faculty of Pharmacy, Lj. (FFALJ)
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Učinkovitost in varnost imunoterapije pri bolnikih z napredovalim nedrobnoceličnim pljučnim rakom zdravljenih v drugi liniji na Kliniki Golnik = Effectivness and safety of immunotherapy in patients with advanced non-small cell lung cancer in second line treatment at the University Clinic Golnik : magistrska naloga : enovit magistrski študijski program FarmacijaLjepojević, TamaraPljučni rak je ena izmed najpogostejših oblik raka na svetu in vodilni vzrok smrti po celem svetu. Nedrobnocelični pljučni rak (NDRP) je najpogostejša oblika pljučnega raka; ker pa je skoraj polovica ... diagnosticirana v napredovali fazi bolezni, je celokupno preživetje teh bolnikov zelo skromno in 5-letno preživetje je manj kot 10 %. V zadnjih letih se je uveljavila terapija z zaviralci imunskih kontrolnih točk (ZKT). Z našo raziskavo smo želeli ugotoviti učinkovitost in varnost ZKT v monoterapiji v drugi liniji zdravljenja napredovalega NDRP pri bolnikih, zdravljenih na Kliniki Golnik v okviru rutinske klinične prakse. Vključili smo 87 bolnikov z napredovalim NDRP brez gonilnih tarčnih sprememb EGFR (angl. epidermal growth factor receptor), ALK (angl. anaplastic lymphoma kinase) in ROS1 (angl. ROS Proto-Oncogene 1, Receptor Tyrosine Kinase), ki so na Kliniki Golnik od julija 2015 do aprila 2022 v okviru rutinske klinične prakse prejeli ZKT (pembrolizumab, atezolizumab ali nivolumab) v drugi liniji zdravljenja. V sklopu analize smo ocenili srednji čas preživetja (angl. median overall survival; mOS), čas zdravljenja (angl. duration of treatment; DOT) ter celokupno preživetje po enem in dveh letih. Naredili smo tudi univariantno in multivariantno analizo, da smo preverili, katere značilnosti bolnika in bolezni vplivajo na izid zdravljenja. Mediana spremljanja bolnikov je bila 38,6 meseca. Vključeni bolniki so bili starejši (mediana starost 65 let); 62 % (54/87) je bila moških in 13 % (11/87) bolnikov je imelo slabši status telesne zmogljivosti (PS ⡥ 2). Bolniki so prejeli atezolizumab 37 % (32/87), nivolumab 33 % (29/87) ali pembrolizumab 30 % (26/87). mDOT je bila 5,0 mesecev (95 % IZ, 2,4 - 8,2), mOS pa 11,8 mesecev (95 % IZ, 10,0-13,6). Enoletno preživetje bolnikov je bilo 53 % in dvoletno preživetje 23 %. Neželeni učinki vseh stopenj so bili prisotni pri 91 % (77/87) bolnikov, hujši (stopnje 3-4) pa pri 17 % (15/17) bolnikov. Smrti zaradi ZKT ni bilo. Izidi učinkovitosti zdravljenja z ZKT pri vključenih bolnikih z mOS 11,8 mesecev so primerljivi s štirimi registracijskimi raziskavami, kjer so mOS bile v intervalu od 9,2 meseca do 12,2 meseca. Pojavnost neželenih učinkov v naši raziskavi se giblje v podobnem obsegu kot v kliničnih raziskavah, z nekoliko višjim izražanjem v primerjavi z opazovalnimi študijami.Type of material - master's thesis ; adult, seriousPublication and manufacture - Ljubljana : [T. Ljepojević], 2023Language - slovenianCOBISS.SI-ID - 173544963
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Knjižnica emšf 0000000615 LJEPOJEVIĆ T. Učinkovit 0000001340 IN: 0017915 Knjižnica emšf 615 LJEPOJEVIĆ T. Učinkovit 1340 IN: 0017915 |
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Ljepojević, Tamara | ![]() |
Knez, Lea, 1981- | 29281 |
Pelicon, Veronika | ![]() |
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