Department of Oncology, Molecular Oncology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China.
Department of Oncology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, China.
Cancer Immunol Immunother. 2024 Mar 30;73(5):79. doi: 10.1007/s00262-024-03663-z.
Pre-clinical data have revealed that viral infection, such as Hepatitis B virus (HBV), Hepatitis C virus (HCV), and Human Papilloma virus (HPV), may lead to the development of "hot" or "immune-sensitive" tumors, which may impact the efficacy of immune checkpoint inhibitor (ICIs). Therefore, This study aimed to investigate the impact of viral status on the efficacy of ICIs.
Electronic databases were searched to identify relevant trials. The primary endpoints were overall survival (OS) and progression-free survival (PFS) measured by hazard ratio (HR). Stratified analyses were accomplished based on viral types, treatment regimens, and patient locations.
A total of 3255 participants were recruited, including 252 cases of gastric cancer, 156 cases of nasopharyngeal carcinoma, 1603 cases of hepatocellular carcinoma, and 1244 cases of head and neck squamous cell carcinoma. Pooled results demonstrated a significant association between viral infection and favorable outcomes in patients receiving ICIs, including improved OS [HR = 0.67, 95%CI (0.57-0.79), P < 0.0001], increased ORR [OR = 1.43, 95%CI (1.14-1.80), P = 0.0018], and a trend toward enhanced PFS [HR = 0.75, 95%CI (0.56-1.00), P = 0.05]. In subgroup analyses, patients treated with ICIs who were exposed to HBV/HCV or HPV infection exhibited an evidently superior OS without heterogeneity, compared to those without infection.
This study indicated that the presence of viral infection was evidently associated with improved outcomes in cancer patients undergoing ICIs, particularly in cases of HBV/HCV and HPV infections.
临床前数据显示，病毒感染（如乙型肝炎病毒（HBV）、丙型肝炎病毒（HCV）和人乳头瘤病毒（HPV））可能导致“热”或“免疫敏感”肿瘤的发展，这可能会影响免疫检查点抑制剂（ICI）的疗效。因此，本研究旨在探讨病毒状态对 ICI 疗效的影响。
检索电子数据库以确定相关试验。主要终点是通过风险比（HR）测量的总生存期（OS）和无进展生存期（PFS）。根据病毒类型、治疗方案和患者位置进行分层分析。
共纳入 3255 名参与者，包括 252 例胃癌、156 例鼻咽癌、1603 例肝细胞癌和 1244 例头颈部鳞状细胞癌。汇总结果表明，病毒感染与接受 ICI 治疗的患者的良好结局之间存在显著关联，包括改善的 OS [HR=0.67，95%CI（0.57-0.79），P<0.0001]、增加的客观缓解率 [OR=1.43，95%CI（1.14-1.80），P=0.0018] 和 PFS 趋势改善 [HR=0.75，95%CI（0.56-1.00），P=0.05]。在亚组分析中，与未感染的患者相比，接受 ICI 治疗且暴露于 HBV/HCV 或 HPV 感染的患者具有明显更优的 OS，且无异质性。
本研究表明，病毒感染的存在与接受 ICI 治疗的癌症患者的改善结局明显相关，尤其是在 HBV/HCV 和 HPV 感染的情况下。
