First Clinic of internal Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy.
IRCCS Ospedale Policlinico San Martino, Genoa - Italian Cardiovascular Network, Genoa, Italy.
Eur J Clin Invest. 2022 Jan;52(1):e13668. doi: 10.1111/eci.13668. Epub 2021 Aug 22.
High circulating levels of cellular adhesion molecules (CAMs) in non-small cell lung cancer (NSCLC) have been supposed to act as a negative prognostic factor. Here, we explored the predictive role of pre-treatment levels of CAMs in previously treated patients receiving nivolumab for NSCLC.
Seventy one patients with advanced NSCLC, treated with nivolumab at the dose of 3 mg/kg every 14 days, were enrolled. Maximum follow-up time was 3 years. Serum levels of Vascular Cell Adhesion Molecule-1 (VCAM-1) and Intracellular Adhesion Molecule-1 (ICAM-1) were measured at baseline and before each nivolumab administration. Endpoints of the study were a composite outcome of survival ≥2 years or absence of disease progression at the end of the follow-up, and the overall survival.
Composite outcome and overall survival were positively associated with VCAM-1 baseline levels and with the reduction of VCAM-1 during the treatment. After adjustment for potential confounders, the change in VCAM-1 serum levels during the treatment was an independent predictor of overall survival.
High baseline serum levels of VCAM-1 are associated with a longer survival in patients treated with nivolumab as second line treatment for NSCLC. Surviving patients experience also a significant reduction in CAMs expression during the treatment. Hence, CAMs might be promising prognostic factors in patients with NSCLC underoing immunotherapy.
非小细胞肺癌（NSCLC）患者循环中细胞黏附分子（CAM）水平升高被认为是一个负性预后因素。在此，我们探讨了在接受纳武利尤单抗二线治疗的 NSCLC 患者中，CAM 治疗前水平的预测作用。
共纳入 71 例接受纳武利尤单抗（3mg/kg，每 14 天 1 次）治疗的晚期 NSCLC 患者。最大随访时间为 3 年。在基线和每次纳武利尤单抗治疗前检测血管细胞黏附分子-1（VCAM-1）和细胞间黏附分子-1（ICAM-1）的血清水平。本研究的终点为随访结束时生存≥2 年或无疾病进展的复合结果和总生存。
复合结果和总生存与 VCAM-1 基线水平以及治疗过程中 VCAM-1 的降低呈正相关。在校正潜在混杂因素后，治疗过程中 VCAM-1 血清水平的变化是总生存的独立预测因子。
基线时血清 VCAM-1 水平较高的患者接受纳武利尤单抗二线治疗 NSCLC 的生存时间更长。存活患者在治疗过程中也经历了 CAMs 表达的显著降低。因此，CAMs 可能是接受免疫治疗的 NSCLC 患者有前途的预后因素。
