Peng Yun, Qi Qiufeng, Zhu Ming, Zhang Yaping, Bao Yanqing, Liu Yongping
Clinical Oncology Laboratory, Changzhou Tumor Hospital, Changzhou, Jiangsu Province 213002, China.
Clinical Oncology Laboratory, Changzhou Tumor Hospital, Changzhou, Jiangsu Province 213002, China; Department of Oncology, Changzhou Tumor Hospital, Changzhou, Jiangsu Province 213002, China.
Int Immunopharmacol. 2023 Nov;124(Pt A):110888. doi: 10.1016/j.intimp.2023.110888. Epub 2023 Sep 8.
Targeted anti-programmed death receptor 1 (PD-1) monoclonal antibodies, when combined with chemotherapy, have shown improved outcomes in non-small cell lung cancer (NSCLC). However, it is important to note that not all patients benefit from this treatment, and there is a pressing need for more reliable efficacy measures and potential predictors of outcome. Cytokines, which are important molecules in the immune system, have been considered as potential biomarkers in clinical settings, but their precise clinical use remains unclear. In this study, our objective was to assess whether the levels of cytokines in the patient's blood sample are associated with tumor response to anti-PD-1 monoclonal antibodies combined with chemotherapy as well as the survival of patients with advanced non-small cell lung cancer.
A total of 12 plasma cytokines were measured in advanced NSCLC patients (n = 35) and healthy individuals (n = 26) using multi-microsphere flow immunofluorescence. The relationship between cytokine levels and clinical response was analyzed using nonparametric Wilcoxon matched-pair ranked tests. Progression-free survival (PFS) time was recorded for all patients through radiographic outcome assessment and telephone follow-up. Survival curves were generated using the Kaplan-Meier and log-rank tests, and the thresholds for cytokines were determined using receiver operating characteristic analysis (ROC).
The expression levels of interleukin IL-6, IL-1 β, IFN-γ, IL-12p70, and TNF-α were significantly lower in the control group than those in the NSCLC group (p = 0.001, p = 0.0028, p = 0.019, p = 0.0001, p = 0.0021). High IL-10 levels at baseline and after 4 cycles of treatment conferred a worse prognosis; in addition, high TNF-α levels in patients after two cycles of immunochemotherapy suggested drug resistance. High levels of IL-6 and IFN-γ in patients undergoing four cycles of immunochemotherapy were associated with worse PFS.
Our study suggests that cytokines can serve as detection indicators for predicting efficacy in non-small cell lung cancer patients undergoing anti-PD-1 combined with chemotherapy treatment. Elevated levels of IL-10, TNF-α, IL-6, and IFN-γ in the plasma may indicate a higher likelihood of experiencing a worse clinical outcome.
靶向程序性死亡受体1(PD-1)单克隆抗体与化疗联合使用时,已显示出在非小细胞肺癌(NSCLC)治疗中能改善疗效。然而,需要注意的是,并非所有患者都能从这种治疗中获益,因此迫切需要更可靠的疗效评估指标和潜在的预后预测指标。细胞因子作为免疫系统中的重要分子,已被视为临床环境中的潜在生物标志物,但其确切的临床应用仍不明确。在本研究中,我们的目的是评估患者血液样本中的细胞因子水平是否与抗PD-1单克隆抗体联合化疗的肿瘤反应以及晚期非小细胞肺癌患者的生存率相关。
使用多微球流动免疫荧光法对35例晚期NSCLC患者和26例健康个体的12种血浆细胞因子进行检测。采用非参数Wilcoxon配对秩和检验分析细胞因子水平与临床反应之间的关系。通过影像学结果评估和电话随访记录所有患者的无进展生存期(PFS)。使用Kaplan-Meier法和对数秩检验生成生存曲线,并通过受试者工作特征分析(ROC)确定细胞因子的阈值。
对照组中白细胞介素IL-6、IL-1β、IFN-γ、IL-12p70和TNF-α的表达水平显著低于NSCLC组(p = 0.001,p = 0·0028,p = 0.019,p = 0.0001,p = 0.0021)。基线时和4个周期治疗后的高IL-10水平预示着更差的预后;此外,免疫化疗两个周期后患者的高TNF-α水平提示耐药。接受4个周期免疫化疗的患者中,高IL-6和IFN-γ水平与更差的PFS相关。
我们的研究表明,细胞因子可作为预测接受抗PD-1联合化疗治疗的非小细胞肺癌患者疗效的检测指标。血浆中IL-10、TNF-α、IL-6和IFN-γ水平升高可能表明临床结局较差的可能性更高。