ICTriplex Triplet Strategy Achieves 47.9% Complete Remission in Advanced, Refractory Malignancies
核心洞察
A personalized triplet strategy combining chemotherapy, immune checkpoint inhibitors, and targeted therapy (ICTriplex) achieved a 47.9% complete remission rate in 73 evaluable patients with advanced, refractory malignancies.
The overall remission rate reached 87.6%, with complete remission significantly associated with a median progression-free survival of 15 months and median overall survival of 41 months.
Lung cancer (搜索) proved the most sensitive tumor type, with a 64% complete remission rate, and four patients considered terminal before treatment remain alive and disease-free at 5 years.
A personalized triplet combination of chemotherapy, immune checkpoint inhibitors, and targeted therapy—termed ICTriplex—achieved a complete remission rate of 47.9% in patients with advanced and refractory malignancies previously considered terminal or refractory to conventional therapy. The data were presented in June at the 2026 ASCO Breakthrough Conference in Singapore by Philip A. Salem, MD, President of the Salem Oncology Center (搜索).
ICTriplex is a therapeutic strategy rather than a single specific treatment. In this approach, every patient receives the combination, but no two patients receive the same treatment. Therapy is highly personalized and tailored to the individual patient and his or her specific cancer, with treatment designed based on the individual's diagnosis, prior therapy, and the biological identity of the tumor, as determined through biological and genomic profiling.
Rationale and Study Design
The strategy rests on the premise that, at the biological and genomic level, every cancer is unique, and one patient's disease is distinctly different from another patient who may share the same microscopic and anatomic diagnosis. ICTriplex represents an attempt to utilize this biological uniqueness to design highly personalized treatment while simultaneously employing the three therapeutic modalities of chemotherapy, immunotherapy, and targeted treatment.
Between March 2017 and February 2026, a total of 73 evaluable patients with advanced malignancies considered terminal by standard criteria or refractory to conventional therapy were treated at a single center (Salem Oncology Center (搜索), Houston). All patients were considered evaluable except those who did not complete one cycle of therapy.
In designing the treatment program, the chemotherapy component was selected as the best available standard treatment, primarily taxanes, gemcitabine, and platinum agents. Immunotherapy with immune checkpoint inhibitors—primarily atezolizumab, nivolumab, and pembrolizumab—was added, along with targeted therapy, primarily bevacizumab and erlotinib. Extensive genomic studies of the tumor were critical to treatment design.
Patient Population and Outcomes
Tumor types were diverse and included lung (n = 14), colorectal (n = 13), pancreatic (n = 11), biliary tract (n = 6), breast (n = 6), ovarian (n = 4), sarcoma (n = 4), glioblastoma multiforme (n = 3), melanoma (n = 3), gastric (n = 3), cervical (n = 2), and others (n = 4).
Objective responses were observed across multiple tumor types. Complete remissions were achieved in all types of cancer treated, except in ovarian cancer and sarcoma. Across all groups, the complete remission rate was 47.9%, the partial remission rate was 39.7%, and the overall remission rate was 87.6%.
Lung cancer (搜索) was the most sensitive tumor type, with a complete remission rate of 64%. Among 5 patients with lung cancer and brain metastasis, complete remission in the brain was achieved in 4 when complete remission was achieved systemically; one patient achieved complete remission systemically but not in the brain.
Of the total 73 patients, 4 who were considered terminal prior to treatment are now alive and free of disease at 5 years.
Survival and Safety
Complete remission in this study was significantly associated with improved outcomes, with a median progression-free survival of 15 months and a median overall survival of 41 months. Progression-free survival and overall survival rates were estimated using Kaplan-Meier methodology.
A patient was considered in complete remission only when his or her PET/CT scan was negative; a negative CT scan was not considered complete remission if the PET/CT showed residual metabolic activity. All patients were rigorously followed and monitored in a single center.
Fatal complications occurred in 3 patients, and these complications were possibly but not definitively related to checkpoint inhibitors. Other toxicities were manageable and within the expected range.
Clinical Significance
In view of the complete remission rate of 47.9% achieved in a category of patients previously considered to have terminal advanced or refractory cancer, the authors describe this strategy as a new and innovative approach to the treatment of advanced cancer. Continued study of the role and usefulness of ICTriplex is warranted, and ICTriplex should be considered an option for patients with advanced and refractory malignancies who have exhausted standard therapy or who lack a known optimal therapy.
The findings confirm and extend previously reported data and support ICTriplex as an appropriate option for patients with advanced malignancies for whom no standard treatment is available.