Department of Rheumatology and Immuology, The Fourth Hospital of Hebei Medical University, 12 Jiankang Road, Shijiazhuang, 050011, People's Republic of China.
School of Basic Medicine, Hebei Medical University, Shijiazhuang, People's Republic of China.
BMC Cancer. 2022 Nov 5;22(1):1136. doi: 10.1186/s12885-022-10199-x.
Immune checkpoint inhibitors (ICIs) has shown remarkable benefit in the treatment of a range of cancer types, although it may initiate immune related adverse events (irAEs) in patients. Some studies have shown that there is a close relationship between the occurrence of irAEs and prognosis. In present study, we have attempted to establish whether the occurrence of irAEs after the use of anti PD-1 antibodies is associated with treatment efficacy in people with advanced gastric cancer (AGC).
This study included patients treated with the anti-PD-1 antibodies for AGC patients at The Fourth Hospital of Hebei Medical University. IrAEs were identified clinically and graded as per the National Cancer Institute Common Terminology Criteria for Adverse Events ver. 4.03. Efficacy was evaluated with objective response rate (ORR), disease control rate (DCR), progression free survival (PFS) and overall survival (OS). The analysis was performed to determine the association between irAEs and clinical outcomes.
Of the 74 AGC patients in our study, 24 developed irAEs. The DCR of the irAE displayed a trend better than that of non-irAE group but without statistical difference (41.70% VS 6.0%, p = 0.118). Median PFS in the irAE group was superior to that in the non-irAE group (176 days VS 94 days, p = 0.001). Median OS also showed this trend of difference at borderline statistical level (292 days VS 239 days, p = 0.057). Multivariate analysis also demonstrated irAE (HR = 0.269, 95%CI: 0.088 to 0.822, p = 0.021) were associated independently with the better prognosis for AGC patients.
In advanced gastric cancer treated with anti PD-1 antibodies, the occourence of irAEs might contribute to the improved prognosis.
免疫检查点抑制剂（ICIs）在治疗多种癌症类型方面显示出显著的益处，尽管它可能会在患者中引发免疫相关不良事件（irAEs）。一些研究表明，irAEs 的发生与预后密切相关。在本研究中，我们试图确定抗 PD-1 抗体治疗后 irAEs 的发生是否与晚期胃癌（AGC）患者的治疗效果相关。
本研究纳入了在河北医科大学第四医院接受抗 PD-1 抗体治疗的 AGC 患者。irAEs 通过临床识别并根据国家癌症研究所不良事件通用术语标准 4.03 版进行分级。采用客观缓解率（ORR）、疾病控制率（DCR）、无进展生存期（PFS）和总生存期（OS）评估疗效。进行分析以确定 irAEs 与临床结果之间的关系。
在我们的研究中，74 名 AGC 患者中有 24 名发生了 irAEs。irAE 组的 DCR 显示出优于非 irAE 组的趋势，但无统计学差异（41.70% VS 6.0%，p=0.118）。irAE 组的中位 PFS 优于非 irAE 组（176 天 VS 94 天，p=0.001）。中位 OS 也显示出这种差异的趋势，但具有边缘统计学意义（292 天 VS 239 天，p=0.057）。多变量分析也表明，irAE（HR=0.269，95%CI：0.088 至 0.822，p=0.021）与 AGC 患者的更好预后独立相关。
在接受抗 PD-1 抗体治疗的晚期胃癌中，irAEs 的发生可能有助于改善预后。
