Noori Maryam, Fayyaz Farimah, Zali Mohammad Reza, Bashash Davood
Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran.
Expert Rev Anticancer Ther. 2023 Jul-Dec;23(9):1029-1039. doi: 10.1080/14737140.2023.2238896. Epub 2023 Jul 27.
Which patients may benefit more from immune checkpoint inhibitors (ICIs) is still an important question. The present study aimed to investigate the role of the PD-L1 molecule in predicting the effectiveness of PD-1/PD-L1 inhibitors in gastric cancer patients.
We searched PubMed, Scopus, Web of Science, and EMBASE databases as of 25 March 202225 March 2022.
Ten articles were included. When we used the TPS method for PD-L1 expression, none of the patients in tumor proportion score (TPS)≥1% and TPS < 1% groups took advantage of ICI therapy in terms of OS and PFS. However, gastric cancer patients with combined-positive score (CPS)≥1, CPS ≥ 5, and CPS ≥ 10 tumors represented superior OS for ICIs over the control agents, while their counterparts (i.e. patients with CPS < 1, CPS < 5, and CPS < 10 tumors) did not. In the subgroup analysis when patients with CPS ≥ 1 were selected, Nivolumab improved the OS and PFS remarkably by 26% and 25% when compared with control agents, respectively. However, Pembrolizumab significantly increased the rate of disease progression by 47% relative to the control medications.
Among patients suffering from gastric cancer, considering PD-L1 CPS thresholds seems to be a more reliable predictive factor than TPS threshold for lower rate of mortality when PD-1/PD-L1 inhibitors are administered.
哪些患者可能从免疫检查点抑制剂（ICI）中获益更多仍是一个重要问题。本研究旨在探讨PD-L1分子在预测PD-1/PD-L1抑制剂对胃癌患者疗效中的作用。
我们检索了截至2022年3月25日的PubMed、Scopus、科学网和EMBASE数据库。
纳入10篇文章。当我们使用TPS方法评估PD-L1表达时，肿瘤比例评分（TPS）≥1%组和TPS＜1%组的患者在总生存期（OS）和无进展生存期（PFS）方面均未从ICI治疗中获益。然而，联合阳性评分（CPS）≥1、CPS≥5和CPS≥10的胃癌患者使用ICI的OS优于对照药物，而CPS＜1、CPS＜5和CPS＜10的患者则不然。在亚组分析中，选择CPS≥1的患者时，与对照药物相比，纳武利尤单抗显著提高了OS和PFS，分别提高了26%和25%。然而，帕博利珠单抗相对于对照药物显著增加了疾病进展率，达47%。
在胃癌患者中，使用PD-1/PD-L1抑制剂时，考虑PD-L1 CPS阈值似乎比TPS阈值更可靠，可降低死亡率。
