Department of Respiratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China.
Department of Respiratory Disease, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
Thorac Cancer. 2019 May;10(5):1303-1309. doi: 10.1111/1759-7714.13078. Epub 2019 Apr 23.
According to multiple studies, the objective response rate of PD-1/PD-L1 inhibitors in the second-line treatment of unscreened non-small cell lung cancer (NSCLC) is only approximately 20%. Predictive biomarkers of treatment efficacies are still under investigation. In selected NSCLC patients with PD-L1 expression ≥ 50%, the response rate of pembrolizumab in first-line treatment can reach 44.8%. Moreover, patients with a higher tumor mutation burden (TMB) tend to achieve a better response with nivolumab. Besides PD-L1 expression and TMB, taking all these indicators into consideration would hypothetically maximize the clinical response in a specific subgroup of patients. Our study aims to accumulate large and complete samples and clinical data to verify the biomarkers and their cutoff values related to the efficacy of PD-1/PD-L1 inhibitors in Chinese NSCLC patients, and to construct a comprehensive predictive model by combining multi-omics data with contemporary machine learning techniques. NSCLC patients administered treatment of anti-PD-1/PD-L1 antibodies or a combination with other drugs have been enrolled. The estimated enrollment is 250 participants. A sophisticated predictive model of immunotherapy response in the Chinese population has not yet been developed. It is clinically and practically imperative to comprehensively evaluate the possible indicators of Chinese NSCLC patients through multiple test platforms, such as next generation sequencing, PCR, or immunohistochemistry. This study is registered in the Chinese Clinical Trial Registry (ChiCTR1900021395).
根据多项研究,PD-1/PD-L1 抑制剂在未经筛选的非小细胞肺癌(NSCLC)二线治疗中的客观缓解率仅约为 20%。治疗效果的预测生物标志物仍在研究中。在 PD-L1 表达≥50%的选定 NSCLC 患者中,帕博利珠单抗作为一线治疗的缓解率可达 44.8%。此外,肿瘤突变负荷(TMB)较高的患者使用纳武利尤单抗可能会获得更好的应答。除 PD-L1 表达和 TMB 外,综合考虑所有这些指标可以在特定的患者亚组中理论上最大限度地提高临床应答率。本研究旨在积累大量完整的样本和临床数据,验证与中国 NSCLC 患者的 PD-1/PD-L1 抑制剂疗效相关的生物标志物及其临界值,并通过结合多组学数据和现代机器学习技术构建综合预测模型。已入组接受抗 PD-1/PD-L1 抗体治疗或联合其他药物治疗的 NSCLC 患者。预计入组 250 名参与者。尚未开发出针对中国人群免疫治疗反应的复杂预测模型。通过下一代测序、PCR 或免疫组织化学等多个检测平台,全面评估中国 NSCLC 患者的可能指标在临床上和实际上都是必要的。本研究在中国临床试验注册中心(ChiCTR1900021395)注册。