记忆性CD8(+) T细胞对人类癌症免疫治疗的预后影响：一项系统评价和荟萃分析
Prognostic Impact of Memory CD8(+) T Cells on Immunotherapy in Human Cancers: A Systematic Review and Meta-Analysis.
作者信息
Jin Yao, Tan Aili, Feng Jia, Xu Zexi, Wang Peiwei, Ruan Peng, Luo Ruijun, Weng Yiming, Peng Min
机构信息
Department of Oncology, Renmin Hospital of Wuhan University, Wuhan, China.
Department of Obstetrics & Gynecology, Renmin Hospital of Wuhan University, Wuhan, China.
出版信息
Front Oncol. 2021 Jun 25;11:698076. doi: 10.3389/fonc.2021.698076. eCollection 2021.
OBJECTIVE
The objective of this systematic review and meta-analysis was to determine the prognostic value of memory CD8(+) T cells in cancer patients with immunotherapy.
METHODS
EMBASE, MEDLINE (PubMed), and Web of Science databases were searched to identify suitabile articles published before March 2021. Risk of bias on the study level was assessed using the Cochrane Bias Risk Assessment Tool. The hazard ratios (HRs) and 95% confidence intervals (CIs) of pooled progression-free survival (PFS) and overall survival (OS) were calculated using RevMan 5.4 to evaluate the prognostic impact of memory CD8(+) T cells.
RESULTS
In total, nine studies were included in the final analysis. High levels of memory CD8(+) T cells were significantly closely correlated with better progression-free survival (PFS) and overall survival (OS) of cancer patients with immunotherapy (PFS, HR 0.64, 95% CI 0.53-0.78; OS, HR 0.37, 95% CI 0.21-0.65). Memory CD8(+) T cells still have significant prognostic value in cancer patients given immunotherapy alone after excluding of other interfering factors such as chemotherapy, radiotherapy, and targeted therapy (PFS, HR 0.65, 95% CI 0.48-0.89; OS, HR 0.23, 95% CI 0.13-0.42). However, high memory CD8(+) T cells levels did not correspond to a longer PFS or OS in cancer patients with non-immunotherapy (PFS, HR 1.05, 95% CI 0.63-1.73; OS, HR 1.29, 95% CI 0.48-3.48). Thus, memory CD8(+) T cells might be a promising predictor in cancer patients with immunotherapy.
CONCLUSIONS
The host's overall immune status, and not only the tumor itself, should be considered to predict the efficacy of immunotherapy in cancer patients. This study is the first to show the significant prognostic value of memory CD8(+) T cells in immunotherapy of cancer patients through systematic review and meta-analysis. Thus, the detection of memory CD8(+) T cells has a considerable value in clinical practice in cancer patients with immunotherapy. Memory CD8(+) T cells may be promising immunotherapy targets.
目的
本系统评价和荟萃分析的目的是确定记忆性CD8(+) T细胞在接受免疫治疗的癌症患者中的预后价值。
方法
检索EMBASE、MEDLINE（PubMed）和Web of Science数据库，以识别2021年3月之前发表的合适文章。使用Cochrane偏倚风险评估工具评估研究水平的偏倚风险。使用RevMan 5.4计算汇总的无进展生存期（PFS）和总生存期（OS）的风险比（HRs）及95%置信区间（CIs），以评估记忆性CD8(+) T细胞的预后影响。
结果
最终分析共纳入9项研究。高水平的记忆性CD8(+) T细胞与接受免疫治疗的癌症患者更好的无进展生存期（PFS）和总生存期（OS）显著密切相关（PFS，HR 0.64，95% CI 0.53 - 0.78；OS，HR 0.37，95% CI 0.21 - 0.65）。在排除化疗、放疗和靶向治疗等其他干扰因素后，记忆性CD8(+) T细胞在仅接受免疫治疗的癌症患者中仍具有显著的预后价值（PFS，HR 0.65，95% CI 0.48 - 0.89；OS，HR 0.23，95% CI 0.13 - 0.42）。然而，在接受非免疫治疗的癌症患者中，高水平的记忆性CD8(+) T细胞与更长的PFS或OS无关（PFS，HR 1.05，95% CI 0.63 - 1.73；OS，HR 1.29，95% CI 0.48 - 3.48）。因此，记忆性CD8(+) T细胞可能是接受免疫治疗的癌症患者的一个有前景的预测指标。
结论
预测癌症患者免疫治疗疗效时应考虑宿主的整体免疫状态，而不仅仅是肿瘤本身。本研究首次通过系统评价和荟萃分析表明记忆性CD8(+) T细胞在癌症患者免疫治疗中具有显著的预后价值。因此，检测记忆性CD8(+) T细胞在接受免疫治疗的癌症患者的临床实践中具有相当大的价值。记忆性CD8(+) T细胞可能是有前景的免疫治疗靶点。
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