Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Thorac Cancer. 2020 Nov;11(11):3337-3345. doi: 10.1111/1759-7714.13677. Epub 2020 Oct 5.
The establishment of biomarkers that can be used to predict the response to immunotherapy for malignancy is extremely important. In particular, noninvasive analysis of immune cells from peripheral blood before treatment has gained increased attention, and natural killer (NK) cell activity has been shown to be related to treatment response. Here, we aimed to confirm the relationship between the response to immunotherapy and NK cell activity.
In this prospective observational study, patients with advanced NSCLC who were scheduled for immunotherapy from October 2018 to December 2019 were enrolled. Baseline NK cell activity was compared according to the best clinical response to immunotherapy.
A total of 54 patients with advanced NSCLC were enrolled, and 34 patients were analyzed. The baseline NK cell activity was significantly higher in the non-PD group than in the PD group (P = 0.002). At the cutoff level of ≥1200 pg/mL, baseline NK cell activity yielded a sensitivity of 80% and a specificity of 68.4% in predicting the response to immunotherapy (AUC = 0.8, P < 0.003). The median progression-free survival (PFS) was significantly better in the high NK group (P = 0.003), and correlation between baseline NK cell activity and PFS was also confirmed (r = 0.517, P = 0.002).
Baseline NK cell activity was related to the response to immunotherapy and the PFS. We suggest that NK cell activity from peripheral blood before immunotherapy is a noninvasive, simple, and novel way to predicting the treatment response in patients with NSCLC.
SIGNIFICANT FINDINGS OF THE STUDY: The response to immunotherapy was significantly better in patients with high baseline NK cell activity, and there was a significant correlation between baseline NK cell activity and PFS. What this study adds This study demonstrates the efficacy of baseline NK cell activity from peripheral blood as a biomarker for predicting immunotherapy response.
建立可用于预测恶性肿瘤免疫治疗反应的生物标志物非常重要。特别是，治疗前外周血免疫细胞的非侵入性分析受到了越来越多的关注，并且已经表明自然杀伤 (NK) 细胞活性与治疗反应有关。在这里，我们旨在确认免疫治疗反应与 NK 细胞活性之间的关系。
在这项前瞻性观察性研究中，纳入了 2018 年 10 月至 2019 年 12 月计划接受免疫治疗的晚期 NSCLC 患者。根据免疫治疗的最佳临床反应比较了基线 NK 细胞活性。
共纳入 54 例晚期 NSCLC 患者，分析了 34 例患者。非 PD 组的基线 NK 细胞活性明显高于 PD 组（P = 0.002）。在 ≥1200 pg/mL 的截断水平，基线 NK 细胞活性预测免疫治疗反应的灵敏度为 80%，特异性为 68.4%（AUC = 0.8，P < 0.003）。高 NK 组的中位无进展生存期（PFS）明显更好（P = 0.003），并且还证实了基线 NK 细胞活性与 PFS 之间的相关性（r = 0.517，P = 0.002）。
基线 NK 细胞活性与免疫治疗反应和 PFS 相关。我们建议，免疫治疗前外周血中的 NK 细胞活性是一种非侵入性、简单且新颖的方法，可以预测 NSCLC 患者的治疗反应。
研究的重要发现：基线 NK 细胞活性高的患者免疫治疗反应更好，并且基线 NK 细胞活性与 PFS 之间存在显著相关性。本研究的意义本研究证明了外周血基线 NK 细胞活性作为预测免疫治疗反应的生物标志物的功效。
