Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 71067Sun Yat-sen University Cancer Center, Guangzhou, China.
Department of Endoscopy, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 71067Sun Yat-sen University Cancer Center, Guangzhou, China.
Cancer Control. 2023 Jan-Dec;30:10732748221148912. doi: 10.1177/10732748221148912.
We aimed to investigate the determinant factors of anti-PD-1 therapy outcome in nasopharyngeal carcinoma (NPC).
In this retrospective study, we included 64 patients with recurrent/metastatic NPC. The association of patients' characteristics, C-reactive protein (CRP), neutrophil to lymphocyte ratio (NLR), and lactate dehydrogenase (LDH) with survival benefit of anti-PD-1 therapy were analyzed using Cox regression models and Kaplan-Meier analyses. Patients were divided based on the median value of CRP, NLR or LDH into different subgroups.
At a median follow-up time of 11.4 months (range: 1-28 months), median progression-free survival (PFS) and overall survival (OS) were 1.9 months (95% CI, .18-3.6) and 15 months (95% CI, 10.9-19.1) months, respectively. Pretreatment metastases numbers was significant predictor of PFS (HR = 1.99; 95% CI 1.10-3.63; = .024) and OS (HR = 2.77; 95% CI 1.36-5.61; = .005). Baseline LDH level was independent predictor of OS (HR = 7.01; 95% CI 3.09-15.88; < .001). Patients with LDH level >435 U/L at the baseline had significantly shorter PFS and OS compared to patients with LDH level ≤435 U/L (median PFS: 1.7 vs 3.5 months, = .040; median OS: 3.7 vs 18.5 months, < .001). Patients with non-durable clinical benefit (NDB) had significantly higher LDH level at the baseline compared to patients who achieved durable clinical benefit (DCB) ( = .025). Post-treatment levels of CRP, LDH, and NLR were decreased compared to baseline in patients with DCB ( = .030, = .088, and = .066, respectively), whereas, there was a significant increase in post-treatment level of LDH compared with baseline in patients with NDB ( = .024).
LDH level at the baseline was an independent predictor of OS and pretreatment metastases numbers was a significant predictor of PFS and OS.
我们旨在研究抗 PD-1 治疗鼻咽癌（NPC）的结果的决定因素。
在这项回顾性研究中，我们纳入了 64 例复发性/转移性 NPC 患者。使用 Cox 回归模型和 Kaplan-Meier 分析，分析了患者特征、C-反应蛋白（CRP）、中性粒细胞与淋巴细胞比值（NLR）和乳酸脱氢酶（LDH）与抗 PD-1 治疗生存获益的相关性。根据 CRP、NLR 或 LDH 的中位数将患者分为不同的亚组。
中位随访时间为 11.4 个月（范围：1-28 个月），中位无进展生存期（PFS）和总生存期（OS）分别为 1.9 个月（95%CI，0.18-3.6）和 15 个月（95%CI，10.9-19.1）个月。治疗前转移灶数量是 PFS（HR=1.99；95%CI 1.10-3.63； =.024）和 OS（HR=2.77；95%CI 1.36-5.61； =.005）的显著预测因子。基线 LDH 水平是 OS 的独立预测因子（HR=7.01；95%CI 3.09-15.88； <.001）。基线时 LDH 水平 >435U/L 的患者的 PFS 和 OS 明显短于 LDH 水平 ≤435U/L 的患者（中位 PFS：1.7 与 3.5 个月， =.040；中位 OS：3.7 与 18.5 个月， <.001）。非持久临床获益（NDB）患者的基线 LDH 水平明显高于持久临床获益（DCB）患者（ =.025）。在 DCB 患者中，治疗后 CRP、LDH 和 NLR 水平与基线相比均有下降（ =.030、 =.088 和 =.066），而在 NDB 患者中，治疗后 LDH 水平与基线相比显著升高（ =.024）。
基线 LDH 水平是 OS 的独立预测因子，而治疗前转移灶数量是 PFS 和 OS 的显著预测因子。
