高级搜索

外周血生物标志物与PD-1/PD-L1抑制剂治疗肺癌疗效的相关性

Correlation Between Peripheral Blood Biomarkers and Efficacy of PD-1/PD-L1 Inhibitors Treatment on Lung Cancer

  • 摘要:
    目的 研究外周血生物标志物对接受PD-1/PD-L1抑制剂治疗的肺癌患者疗效的预测及指导意义。
    方法 收集接受PD-1/PD-L1抑制剂治疗的200例肺癌患者的资料,包括临床指标、外周血指标、疗效指标及生存指标等。
    结果 无肝转移、免疫联合化疗、NLR≤2.81、LDH≤202.5 u/L患者的疾病控制率(DCR)更高(P < 0.05)。NLR联合LDH预测DCR的AUC值为0.698(P < 0.05)。单因素分析示无肝转移、一线免疫治疗、免疫联合化疗、LDH≤202.5 u/L均与PFS有关(P < 0.05)。多因素分析示无肝转移、LDH≤202.5 u/L患者的PFS更长(P < 0.05)。探索性分析示两周期免疫治疗后NLR、LDH的明显下降提示免疫治疗的有效性(P < 0.05)。
    结论 NLR≤2.81、LDH≤202.5 u/L、无肝转移、免疫联合化疗与免疫治疗疗效呈正相关,且无肝转移、LDH≤202.5 u/L是接受免疫治疗患者的独立预后因素。另外,外周血NLR、LDH的变化与PD-1/PD-L1抑制剂的疗效相关。

     

    Abstract:
    Objective To investigate the predictive and guiding significance of peripheral blood biomarkers on the therapeutic effects of PD-1/PD-L1 inhibitor treatment on lung cancer patients.
    Methods We collected the data of 200 lung cancer patients treated with PD-1/PD-L1 inhibitors treatment, including clinical indicators, peripheral blood indicators, efficacy indicators and survival indicators.
    Results The DCR of patients with non-hepatic metastasis, immune combined chemotherapy, NLR≤2.81 and LDH≤202.5 u/L was higher (P < 0.05). The AUC value of NLR combined with LDH predicting DCR was 0.698 (P < 0.05). Univariate analysis showed that non-hepatic metastasis, first-line immunotherapy, immunotherapy combined with chemotherapy and LDH≤202.5 u/L were related to PFS (P < 0.05). Multivariate analysis showed that the patients with non-hepatic metastasis and LDH≤202.5 u/L had longer PFS (P < 0.05). The significant decrease of NLR and LDH after two cycles of immunotherapy indicated the effectiveness of immunotherapy (P < 0.05).
    Conclusion NLR≤2.81, LDH≤202.5 u/L, non-hepatic metastasis and immunotherapy combined chemotherapy are positively correlated with immunotherapy efficacy. Non-hepatic metastasis and LDH≤202.5 u/L are independent prognostic factors of the patients treated with immunotherapy. The changes of peripheral blood NLR and LDH are related to the efficacy of PD-1/PD-L1 inhibitors treatment.

     

/

返回文章
返回