Si Han, Fu Xiaoshuang, Hao Yue, Wang Yina, Lin Gen, Wang Dong, Xu Chunwei, Zhang Yongchang, Song Zhengbo
Postgraduate Training Base Alliance of Wenzhou Medical University (Zhejiang Cancer Hospital), Hangzhou, China.
Department of Clinical Trial, Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, No.1 East Banshan Road, Gongshu District, Hangzhou, 310022, Zhejiang, China.
Clin Transl Oncol. 2025 Feb;27(2):542-548. doi: 10.1007/s12094-024-03618-x. Epub 2024 Jul 24.
The significant expression of PD-L1 in thymic epithelial tumors (TETs) has been confirmed, and immunotherapy and its combination therapy have been effective in TETs. However, there is no present evidence that the expression levels of PD-L1 affects the efficacy of combination therapy. Our study aimed to shed light on this relationship.
Patients with thymic epithelial tumors (TETs) from multicenter hospitals were retrospectively identified. Objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and immune-related adverse events (irAEs) in 22 patients were included. We divided the patients the 22 patients with PD-L1 test into three levels (high expression, low expression and no expression) and analyzed the relationship between the levels of PD-L1 expression and the efficacy of combination therapy.
Combination therapy showed an effective benefit in 22 patients with TETs, the median PFS (mPFS) was 16 months (95% CI: 8.5-23.5) and the median OS (mOS) was 38 months (95% CI: 21.5-54.5). Cox-regressive analysis found whether PD-L1 expression affected the PFS of patients (p = 0.017). Among the patients with PD-L1 expression, the levels of expression were correlated with curative effect (Kruskal-Wallis test, PFS: P = 0.012; OS: P = 0.01), and high expression group was along with better efficacy than low expression (Wilcoxon test, P = 0.01). Moreover, in 17 patients treated with immunotherapy combined with chemotherapy, the expression of PD-L1 was also associated with efficacy (Kruskal-Wallis test, p = 0.021).
PD-L1 expression affects the PFS of patients. High expression of PD-L1 patients with TETs responded better to combination therapy, which could provide a therapeutic option in clinic. Besides, other targeted treatments should be considered.
已证实程序性死亡受体配体1（PD-L1）在胸腺上皮肿瘤（TETs）中显著表达，免疫疗法及其联合疗法在TETs中已显示出疗效。然而，目前尚无证据表明PD-L1的表达水平会影响联合疗法的疗效。我们的研究旨在阐明这种关系。
对来自多中心医院的胸腺上皮肿瘤（TETs）患者进行回顾性研究。纳入22例患者的客观缓解率（ORR）、无进展生存期（PFS）、总生存期（OS）及免疫相关不良事件（irAEs）。我们将22例接受PD-L1检测的患者分为三个水平（高表达、低表达和无表达），并分析PD-L1表达水平与联合疗法疗效之间的关系。
联合疗法在22例TETs患者中显示出有效获益，中位无进展生存期（mPFS）为16个月（95%置信区间：8.5 - 23.5），中位总生存期（mOS）为38个月（95%置信区间：21.5 - 54.5）。Cox回归分析发现PD-L1表达是否影响患者的PFS（p = 0.017）。在有PD-L1表达的患者中，表达水平与疗效相关（Kruskal-Wallis检验，PFS：P = 0.012；OS：P = 0.01），高表达组的疗效优于低表达组（Wilcoxon检验，P = 0.01）。此外，在接受免疫疗法联合化疗的17例患者中，PD-L1的表达也与疗效相关（Kruskal-Wallis检验，p = 0.021）。
PD-L1表达影响患者的PFS。TETs中PD-L1高表达的患者对联合疗法反应更好，这可为临床提供一种治疗选择。此外，应考虑其他靶向治疗。
