微卫星不稳定性、爱泼斯坦-巴尔病毒和程序性细胞死亡配体1作为胃癌免疫治疗的预测标志物

Microsatellite Instability, Epstein-Barr Virus, and Programmed Cell Death Ligand 1 as Predictive Markers for Immunotherapy in Gastric Cancer.

作者信息

Yu Hung-Yuan, Li Chung-Pin, Huang Yi-Hsiang, Hsu Shao-Jung, Wang Yen-Po, Hsieh Yun-Cheng, Fang Wen-Liang, Huang Kuo-Hung, Li Anna Fen-Yau, Lee Rheun-Chuan, Lee Kang-Lung, Wu Yuan-Hung, Lai I-Chun, Yang Wan-Chin, Hung Yi-Ping, Wang Yu-Chao, Chen Shu-Hui, Chen Ming-Huang, Chao Yee

机构信息

Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei 112201, Taiwan.

Hospitalist Ward, Department of Medicine, Taipei Veterans General Hospital, Taipei 112201, Taiwan.

出版信息

Cancers (Basel). 2022 Jan 3;14(1):218. doi: 10.3390/cancers14010218.

Immunotherapy benefits selected cases of gastric cancer (GC), but the correlation between biomarkers and prognosis is still unclear. Fifty-two patients with GC who underwent immunotherapy were enrolled from June 2016 to December 2020. Their clinical features and biomarkers-microsatellite instability-high (MSI-H), programmed cell death ligand 1 (PD-L1) combined positive score (CPS), and Epstein-Barr encoding region (EBER)-were analyzed. Eight patients had MSI-H, five patients had EBER, 29 patients had CPS ≥ 1, and 20 patients had no biomarker. The overall response rates (ORRs) of the MSI-H, EBER, PD-L1 CPS ≥ 1, and all-negative group were 75%, 60%, 44.8%, and 15%, respectively. Compared with that of the all-negative group, progression-free survival (PFS) was better in the MSI-H ( = 0.018), CPS ≥ 5 ( = 0.012), and CPS ≥ 10 ( = 0.006) groups, but not in the EBER ( = 0.2) and CPS ≥ 1 groups ( = 0.35). Ten patients had combined biomarkers, CPS ≥ 1 with either MSI-H or EBER. The ORRs were 66.7% for CPS ≥ 1 and MSI-H and 75% for CPS ≥ 1 and EBER. PFS was better in patients with combined biomarkers ( = 0.01). MSI-H, EBER, and CPS are useful biomarkers for predicting the efficacy of immunotherapy.

免疫疗法对部分胃癌（GC）病例有益，但生物标志物与预后之间的相关性仍不明确。2016年6月至2020年12月期间，纳入了52例接受免疫疗法的GC患者。分析了他们的临床特征和生物标志物——微卫星高度不稳定（MSI-H）、程序性细胞死亡配体1（PD-L1）联合阳性评分（CPS）以及爱泼斯坦-巴尔编码区（EBER）。8例患者为MSI-H，5例患者为EBER，29例患者CPS≥1，20例患者无生物标志物。MSI-H、EBER、PD-L1 CPS≥1以及全阴性组的总缓解率（ORR）分别为75%、60%、44.8%和15%。与全阴性组相比，MSI-H组（P = 0.018）、CPS≥5组（P = 0.012）和CPS≥10组（P = 0.006）的无进展生存期（PFS）更好，但EBER组（P = 0.2）和CPS≥1组（P = 0.35）并非如此。10例患者具有联合生物标志物，即CPS≥1且伴有MSI-H或EBER。CPS≥1且伴有MSI-H的ORR为66.7%，CPS≥1且伴有EBER的ORR为75%。具有联合生物标志物的患者PFS更好（P = 0.01）。MSI-H、EBER和CPS是预测免疫疗法疗效的有用生物标志物。