Park Chan Su, Sung Min Je, Kim So Jeong, Jo Jung Hyun, Lee Hee Seung, Chung Moon Jae, Bang Seungmin, Park Seung Woo, Song Si Young, Park Jeong Youp
Division of Gastroenterology, Department of Internal Medicine, Yonsei Institute of Gastroenterology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.
Department of Gastroenterology, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam-si 13496, Korea.
Cancers (Basel). 2022 Sep 3;14(17):4323. doi: 10.3390/cancers14174323.
Some BTC types respond to pembrolizumab, but there are no known prognostic factors to predict its treatment benefits. In this study, we attempted to identify the prognostic factors associated with pembrolizumab as a second-line treatment for gemcitabine-refractory BTC. This retrospective and single tertiary-center study involved all the consecutive patients (n = 80) with refractory advanced BTC, who were diagnosed as programmed cell death ligand 1-positive and treated with pembrolizumab between August 2017 and February 2021. The overall survival (OS) was analyzed using Cox regression analysis. The median OS was 6.0 months [95% confidence interval (CI): 3.87−8.20]; median progression-free survival was 1.9 months (95% CI: 1.82−1.98); and the response rate was 15.9%. In the multivariate Cox regression analysis, the TB [adjusted hazard ratio (HR) = 2.286; 95% CI: 1.177−4.440; p = 0.015), albumin levels (adjusted HR = 0.392; 95% CI: 0.211−0.725; p = 0.003), ALP levels (adjusted HR = 1.938; 95% CI: 1.105−3.400; p = 0.021), and LMR (adjusted HR = 0.325; 95% CI: 0.173−0.609; p < 0.001) were identified as significant variables associated with the OS. High albumin levels and LMR and low ALP levels and TB were significantly associated with better OS in patients treated with pembrolizumab.
某些胆管癌（BTC）类型对帕博利珠单抗有反应，但目前尚无已知的预后因素可预测其治疗益处。在本研究中，我们试图确定与帕博利珠单抗作为吉西他滨难治性BTC二线治疗相关的预后因素。这项回顾性单中心研究纳入了2017年8月至2021年2月期间所有连续的难治性晚期BTC患者（n = 80），这些患者被诊断为程序性细胞死亡配体1阳性并接受了帕博利珠单抗治疗。采用Cox回归分析评估总生存期（OS）。中位OS为6.0个月[95%置信区间（CI）：3.87−8.20]；中位无进展生存期为1.9个月（95% CI：1.82−1.98）；缓解率为15.9%。在多因素Cox回归分析中，肿瘤标志物（TB）[调整后风险比（HR）= 2.286；95% CI：1.177−4.440；p = 0.015]、白蛋白水平（调整后HR = 0.392；95% CI：0.211−0.725；p = 0.003）、碱性磷酸酶（ALP）水平（调整后HR = 1.938；95% CI：1.105−3.400；p = 0.021）和淋巴细胞与单核细胞比值（LMR）（调整后HR = 0.325；95% CI：0.173−0.609；p < 0.001）被确定为与OS相关的显著变量。高白蛋白水平和LMR以及低ALP水平和TB与接受帕博利珠单抗治疗患者的更好OS显著相关。
