肺气肿与非小细胞肺癌共存可预测免疫检查点抑制剂的治疗效果。
Coexistence of Emphysema With Non-small-cell Lung Cancer Predicts the Therapeutic Efficacy of Immune Checkpoint Inhibitors.
机构信息
Department of Respiratory Medicine, Hiroshima Citizens Hospital, Hiroshima, Japan;
Department of Respiratory Medicine, Hiroshima General Hospital, Hatsukaichi, Japan.
出版信息
In Vivo. 2021 Jan-Feb;35(1):467-474. doi: 10.21873/invivo.12280.
Abstract
BACKGROUND/AIM: Chronic obstructive pulmonary disease coexisting with non-small-cell lung cancer (NSCLC) was reported to be associated with a longer progression-free survival (PFS) in patients treated with immune checkpoint inhibitors (ICIs). In the present study, we investigated the impact of emphysematous change on the treatment response to ICIs in patients with NSCLC.
PATIENTS AND METHODS
A total of 153 patients with advanced NSCLC who received ICIs (nivolumab, pembrolizumab, or atezolizumab) at our hospital from January 2016 to May 2019 were retrospectively enrolled.
RESULTS
According to the Goddard scoring system, 71 (46.4%) patients were classified as having emphysema and 82 (53.6%) as having no emphysema. Multivariate analysis showed that a good performance status and coexisting emphysema (hazard ratio=0.49; 95% confidence intervaI=0.28-0.84; p=0.010) were independent predictors of a better PFS.
CONCLUSION
Recognizing emphysema coexisting with NSCLC may help predict the therapeutic efficacy of ICIs in such patients.
摘要
背景/目的：有报道称，在接受免疫检查点抑制剂（ICI）治疗的患者中，合并慢性阻塞性肺疾病（COPD）的非小细胞肺癌（NSCLC）与更长的无进展生存期（PFS）相关。本研究旨在探讨肺气肿改变对 NSCLC 患者接受 ICI 治疗反应的影响。
患者和方法
回顾性纳入了 2016 年 1 月至 2019 年 5 月在我院接受 ICI（nivolumab、pembrolizumab 或 atezolizumab）治疗的 153 例晚期 NSCLC 患者。
结果
根据 Goddard 评分系统，71 例（46.4%）患者被归类为存在肺气肿，82 例（53.6%）患者不存在肺气肿。多因素分析显示，较好的体力状况和合并肺气肿（风险比=0.49；95%置信区间=0.28-0.84；p=0.010）是 PFS 更好的独立预测因素。
结论
认识到 NSCLC 合并肺气肿可能有助于预测此类患者接受 ICI 治疗的疗效。
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BMC Pulm Med. 2019 Sep 3;19(1):169. doi: 10.1186/s12890-019-0913-8.
2
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3
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4
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5
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6
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