Department of Thoracic Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, 610041, China.
Department of Pathology, West China Hospital, Sichuan University, Chengdu, 610041, China.
Sci Rep. 2020 Sep 30;10(1):16150. doi: 10.1038/s41598-020-73013-3.
This study aimed to identify potential predictive factors for the survival of advanced lung adenocarcinoma patients undergoing pemetrexed maintenance therapy. 122 advanced lung adenocarcinoma patients who received pemetrexed maintenance therapy were retrospectively analyzed. Kaplan-Meier method with Log-rank test was used for survival analysis. Univariate and multivariate Cox regression were performed to evaluate prognostic factors for overall survival (OS) and progression-free survival (PFS). Bivariate correlation analysis was used for exploratory purpose. For the whole cohort of 122 patients, median PFS was 11.97 months (95% CI 10.611-13.329) and estimated median OS was 45.07 months (95% CI 31.690-58.450). The mPFS of ALK-positive patients was superior to negative patients (18.27 vs. 11.90 months; P = 0.039). Patients with ECOG PS 0 (14.4 vs. 11.1 months; p = 0.040) and patients with single-organ metastasis (19.0 vs. 11.0 months; p = 0.014) had prolonged median PFS. Compared with the low PD-L1 expression group, PFS of high PD-L1 expression group were improved (13.6 vs. 11.1 months, p = 0.104, at 1% cut-off; 17.5 vs. 11.1 months, p = 0.009, at 10% cut-off; and 27.5 vs. 11.4 months, p = 0.005, at 50% cut-off). No differences were found between EGFR positive and negative patients. PD-L1 expression was an independent prognostic factor for both PFS and OS times (PFS: HR, 0.175; P = 0.001; OS: HR, 0.107; P = 0.036). Bivariate correlation showed a significant positive correlation between PD-L1 expression and PFS (correlation coefficient R = 0.485, P < 0.001). High PD-L1 expression could be a potential effective predictor for favorable survival of advanced lung adenocarcinoma patients undergoing pemetrexed maintenance therapy.
本研究旨在确定接受培美曲塞维持治疗的晚期肺腺癌患者生存的潜在预测因素。回顾性分析了 122 例接受培美曲塞维持治疗的晚期肺腺癌患者。采用 Kaplan-Meier 法和 Log-rank 检验进行生存分析。采用单因素和多因素 Cox 回归分析评估总生存期（OS）和无进展生存期（PFS）的预后因素。采用双变量相关性分析进行探索性分析。对于整个 122 例患者队列，中位 PFS 为 11.97 个月（95%CI 10.611-13.329），估计中位 OS 为 45.07 个月（95%CI 31.690-58.450）。ALK 阳性患者的 mPFS 优于阴性患者（18.27 与 11.90 个月；P=0.039）。ECOG PS 0 患者（14.4 与 11.1 个月；p=0.040）和单器官转移患者（19.0 与 11.0 个月；p=0.014）的中位 PFS 延长。与低 PD-L1 表达组相比，高 PD-L1 表达组的 PFS 得到改善（13.6 与 11.1 个月，p=0.104，在 1%截定点；17.5 与 11.1 个月，p=0.009，在 10%截定点；27.5 与 11.4 个月，p=0.005，在 50%截定点）。EGFR 阳性和阴性患者之间无差异。PD-L1 表达是 PFS 和 OS 时间的独立预后因素（PFS：HR 0.175；P=0.001；OS：HR 0.107；P=0.036）。双变量相关性显示 PD-L1 表达与 PFS 之间存在显著正相关（相关系数 R=0.485，P<0.001）。高 PD-L1 表达可能是接受培美曲塞维持治疗的晚期肺腺癌患者生存的潜在有效预测因素。
