基于随机2/3期试验（KEYNOTE-010），2016第4版更新，NCCN小组将派姆单抗作为后续治疗推荐从2A类修改为1类。

Previously (Version 1), the NCCN Panel had a category 2A recommendation for pembrolizumab based on the phase 1 KEYNOTE-001 trial and FDA approval.

基于1期KEYNOTE-001试验和FDA的批准，之前的第1版，NCCN小组将派姆单抗列为2A类推荐。

In addition, the NCCN Panel recommends immune checkpoint inhibitors, such as pembrolizumab and nivolumab, as preferred agents for subsequent therapy.

瑞斯国际健康hpv2030香港杏泽医疗如何会诊

很多家属对订购香港PD1的流程不太清楚，下面瑞斯国际pd1就给大家详细讲解一下如何购香港PD1流程和如何安排会诊事项了。由于治疗癌症的新药PD1属于处方药物所以必须经过香港医生的会诊流程才能够购置。会诊分为三种类型：书面会诊、远程视频会诊、面诊会诊。

书面会诊指的是病人家属把患者的诊断、治疗、复查等资料拍照发香港医生进行会诊看病人能否用药PD1。只有符合用药要求的才能订购。书面会诊优势：费用最低可以2-3天就知道可否用药条件，如果直接去香港面诊不符合用药要求那么也就意味着白跑一趟。

远程视频会诊指的是病人或者家属通过远程视频连线香港医生进行15分钟会诊来明确病人到底能不能用药PD1以及具体用K药还是O药。视频会诊特点：效率较高可以会诊完就知道到底能不能用药，但是费用较高预估3000-4000港币。

面诊会诊指的是家属带病人或者家属携带病人病历到香港进行专家会诊。必须提前5天在瑞斯国际进行预约，到达香港进行面诊专家费用较高2000港币如果再门诊进行注射治疗8000港币治疗费用（K药预估3万多O药1万5多）。

此外，NCCN专家组推荐免疫检查点抑制剂，如派姆单抗和尼鲁单抗作为后续治疗的首选药物。

As previously mentioned, human immune-checkpoint--inhibitor antibodies inhibit the programmed death (PD-1) receptor, which improves antitumor immunity; PD-1 receptors are expressed on activated cytotoxic T-cells.

如前所述，人类免疫检查点抑制剂抗体抑制程序性死亡（PD-1）受体，从而改善抗肿瘤免疫；在活化的细胞毒性T细胞上表达PD-1受体。

A recent randomized phase 2/3 trial (KEYNOTE-010) assessed pembrolizumab in patients with previously treated advanced non-squamous and squamous NSCLC who were PD-L1 positive (≥ 1%); most were current or former smokers.

最近一项随机2/3试验（KEYNOTE-010）评估了派姆单抗治疗既往治疗过的、PD-L1阳性的晚期非鳞和鳞型NSCLC患者（≥1%）；大部分都是当前或既往吸烟者。

There were 3 arms in this trial: pembrolizumab at 2 mg/kg, pembrolizumab at 10 mg/kg, and docetaxel at 75 mg/m2 every 3 weeks.

在这项试验中有3组：派姆单抗2mg/kg、派姆单抗10mg/kg、多西他赛75mg/㎡每3周1次。

The median overall survival was 10.4 months for the lower dose of pembrolizumab, 12.7 months for the higher dose, and 8.5 months for docetaxel.

中位总生存期：派姆单抗较低剂量组为10.4个月、高剂量组为12.7 个月，而多西他赛组为8.5个月。

Overall survival was significantly longer for both doses of pembrolizumab when compared with docetaxel (pembrolizumab 2 mg/kg: HR 0.71; 95% CI, 0.58–0.88; P=.0008) (pembrolizumab 10 mg/kg: (HR 0.61; CI, 0.49–0.75; P<.0001).

与多西他赛相比，两个剂量的派姆单抗组总生存期显著更长（派姆单抗2mg/kg：HR 0.71；95% CI，0.58–0.88；P = 0.0008）（派姆单抗10mg/kg：HR 0.61；CI，0.49–0.75；P<0.0001) 。

For those patients with at least 50% PD-L1 expression in tumor cells, overall survival was also significantly longer at either dose of pembrolizumab when compared with docetaxel (pembrolizumab 2 mg/kg: 14.9 vs. 8.2 months; HR 0.54; 95% CI, 0.38–0.77; P=.0002) (pembrolizumab 10 mg/kg: 17.3 vs. 8.2 months; HR 0.50; CI, 0.36–0.70; P<.0001).