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绝对嗜酸性粒细胞计数可能是识别晚期恶性肿瘤患者接受 PD-1/PD-L1 抑制剂治疗后免疫相关不良事件风险的最佳外周血标志物:一项回顾性分析。

Absolute eosinophil count may be an optimal peripheral blood marker to identify the risk of immune-related adverse events in advanced malignant tumors treated with PD-1/PD-L1 inhibitors: a retrospective analysis.

机构信息

Shijingshan Teaching Hospital of Capital Medical University, Beijing Shijingshan Hospital, #24 Shi Jing Shan Road, Beijing, Shijingshan District, 100040, China.

Department of Oncology, Beijing Friendship Hospital, Capital Medical University, #95 Yong An Road, Beijing, 100050, Xicheng District, China.

出版信息

World J Surg Oncol. 2022 Jul 28;20(1):242. doi: 10.1186/s12957-022-02695-y.


DOI:10.1186/s12957-022-02695-y
PMID:35897018
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9331074/
Abstract

BACKGROUND: This study aimed to investigate the predictive values of serum biomarkers including absolute eosinophil count (AEC), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) with respect to immune-related adverse events (irAEs) during anti-PD-1/PD-L1 inhibitor treatment in patients with advanced malignant tumors. METHODS: We retrospectively analyzed 95 patients with advanced cancer who were treated with anti-PD-1/PD-L1 inhibitors from January 1, 2017, to May 1, 2020, in our cancer center. We then analyzed associations between irAEs and anti-PD-1/PD-L1 inhibitor responses and evaluated the predictive values of serum biomarkers with respect to the risk of irAEs. RESULTS: The incidence of irAEs was 55.8%. There were no statistically significant differences between the irAEs and no-irAEs groups in an objective response rate (ORR) or disease control rate (DCR). However, landmark analysis showed that the irAEs group had better survival after 120 days following the initiation of anti-PD-1/PD-L1 inhibitor treatment, compared with the no-irAEs group. The incidences of irAEs were greater in the high-AEC and low-NLR groups than in the low-AEC and high-NLR groups. Univariate logistic analysis showed that low NLR, ECOG performance status (0-1), and high AEC were risk factors for irAEs. Multivariate logistic analysis showed that high AEC and good ECOG performance status were independent predictors for irAEs. CONCLUSIONS: irAEs may be associated with a survival benefit. Baseline AEC is a strong predictor of irAEs in patients undergoing treatment with anti-PD-1/PD-L1 inhibitors.

摘要

背景:本研究旨在探讨血清生物标志物,包括绝对嗜酸性粒细胞计数(AEC)、中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞比值(PLR),在接受抗 PD-1/PD-L1 抑制剂治疗的晚期恶性肿瘤患者中对免疫相关不良事件(irAEs)的预测价值。

方法:我们回顾性分析了 2017 年 1 月 1 日至 2020 年 5 月 1 日在我们癌症中心接受抗 PD-1/PD-L1 抑制剂治疗的 95 例晚期癌症患者。然后,我们分析了 irAEs 与抗 PD-1/PD-L1 抑制剂反应之间的关系,并评估了血清生物标志物对 irAEs 风险的预测价值。

结果:irAEs 的发生率为 55.8%。irAEs 组和非 irAEs 组在客观缓解率(ORR)或疾病控制率(DCR)方面无统计学差异。然而,里程碑分析显示,与非 irAEs 组相比,irAEs 组在接受抗 PD-1/PD-L1 抑制剂治疗后 120 天的生存情况更好。高 AEC 和低 NLR 组的 irAEs 发生率高于低 AEC 和高 NLR 组。单因素 logistic 分析显示,低 NLR、ECOG 表现状态(0-1)和高 AEC 是 irAEs 的危险因素。多因素 logistic 分析显示,高 AEC 和良好的 ECOG 表现状态是 irAEs 的独立预测因素。

结论:irAEs 可能与生存获益有关。基线 AEC 是接受抗 PD-1/PD-L1 抑制剂治疗的患者发生 irAEs 的强有力预测因子。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a76c/9331074/3c291c6d8f28/12957_2022_2695_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a76c/9331074/ddc6d08132dc/12957_2022_2695_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a76c/9331074/22298910f506/12957_2022_2695_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a76c/9331074/3c291c6d8f28/12957_2022_2695_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a76c/9331074/ddc6d08132dc/12957_2022_2695_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a76c/9331074/22298910f506/12957_2022_2695_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a76c/9331074/3c291c6d8f28/12957_2022_2695_Fig3_HTML.jpg

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[4]
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[5]
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[6]
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[10]
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本文引用的文献

[1]
The benefits and risks of pembrolizumab in combination with chemotherapy as first-line therapy in small-cell lung cancer: a single-arm meta-analysis of noncomparative clinical studies and randomized control trials.

World J Surg Oncol. 2021-10-14

[2]
Clinical impact of PD-L1 expression in triple-negative breast cancer patients with residual tumor burden after neoadjuvant chemotherapy.

World J Surg Oncol. 2021-9-2

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The immune checkpoint regulator PD-L1 expression are associated with clinical progression in prostate cancer.

World J Surg Oncol. 2021-7-16

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Predictive value of pretreatment PD-L1 expression in EGFR-mutant non-small cell lung cancer: a meta-analysis.

World J Surg Oncol. 2021-5-8

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The association between immune-related adverse events and survival outcomes in Asian patients with advanced melanoma receiving anti-PD-1 antibodies.

BMC Cancer. 2020-10-21

[6]
Association of baseline peripheral-blood eosinophil count with immune checkpoint inhibitor-related pneumonitis and clinical outcomes in patients with non-small cell lung cancer receiving immune checkpoint inhibitors.

Lung Cancer. 2020-12

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Immune-Related Adverse Events and Corticosteroid Use for Cancer-Related Symptoms Are Associated With Efficacy in Patients With Non-small Cell Lung Cancer Receiving Anti-PD-(L)1 Blockade Agents.

Front Oncol. 2020-9-7

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The efficacy and safety of combined immune checkpoint inhibitors (nivolumab plus ipilimumab): a systematic review and meta-analysis.

World J Surg Oncol. 2020-7-3

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Neutrophil and lymphocyte blood count as potential predictive indicators of nivolumab efficacy in metastatic non-small-cell lung cancer.

Immunotherapy. 2020-7

[10]
Association of the neutrophil to lymphocyte ratio and clinical outcomes in patients with lung cancer receiving immunotherapy: a meta-analysis.

BMJ Open. 2020-6-3

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