TTF-1 表达对非小细胞肺癌患者免疫治疗及化疗/免疫治疗无进展生存期的影响。
Effect of TTF-1 expression on progression free survival of immunotherapy and chemo-/immunotherapy in patients with non-small cell lung cancer.
机构信息
Klinik für Pneumologie, Kardiologie und internistische Intensivmedizin, Florence Nightingale Krankenhaus, Kaiserswerther Diakonie, Düsseldorf, Germany.
Klinik für Kardiologie, Pneumologie und Angiologie, Medizinische Fakultät, Universitätsklinikum Düsseldorf, Düsseldorf, Germany.
出版信息
J Cancer Res Clin Oncol. 2024 Aug 22;150(8):394. doi: 10.1007/s00432-024-05916-x.
BACKGROUND
The choice between immunotherapy with a checkpoint inhibitor (CPI) and chemo-/immunotherapy (CIT) in patients with NSCLC stage IV is often discussed. There is some data that the effect of chemotherapy is influenced by TTF-1 expression. Little is known about the influence of thyreoid transcription factor 1 (TTF-1) expression on CIT and CPI therapy. We aimed to investigate the relationship between tumor TTF-1 expression and efficacy of CIT and CPI therapy.
PATIENTS AND METHODS
We retrospectively analysed 130 patients (age 68 ± 7 y) with NSCLC stage IV. Only patients with lung adenocarcinoma were included. Patients with ALK, ROS1, RET, MET, NTRK, EGFR, BRAF mutation were excluded. Patients were treated according to the guidelines with either CPI alone (pembrolizumab, nivolumab, atezolizumab, cemiplimab) or CIT (Carboplatin/Pemetrexed/Pembrolizumab, Carboplatin/Paclitaxel/Atezolizumab). We registered patients' characteristics including TTF-1 expression. Group 1 consisted of 40 patients with CPI and TTF-1 expression, group 2 were 26 patients with CPI and with no TTF-1 expression. Group 3 consisted of 41 patients with CIT and TTF-1 expression, group 4 were 23 patients with CIT and with no TTF-1 expression.
RESULTS
Group 1-4 showed comparable patients characteristics. Using cox-regression analysis, we found that TTF-1 expression resulted in an improved progression free survival (PFS) compared to patients with CPI and no TTF-1 expression (18 ± 3,15 vs. 5 ± 0,85 months, p = 0.004, 95% CI: 0,23 - 0,984). In patients, who were treated with CIT, PFS was also increased in patients with TTF-1 expression (9 ± 3,17 vs. 3 ± 0,399 months, p = 0.001, 95% CI: 0,23 - 0,85).
CONCLUSIONS
In a real-life setting, we found that TTF-1 expression is associated with an increased PFS. Patients with chemo-/immunotherapy and immunotherapy seem to have a better therapy response in pulmonary adenocarcinoma with TTF-1 expression.
背景
在 IV 期 NSCLC 患者中，选择免疫检查点抑制剂（CPI）与化疗/免疫治疗（CIT）之间存在争议。有数据表明，化疗的效果受 TTF-1 表达的影响。然而，TTF-1 表达对 CIT 和 CPI 治疗的影响知之甚少。我们旨在研究肿瘤 TTF-1 表达与 CIT 和 CPI 治疗疗效之间的关系。
患者和方法
我们回顾性分析了 130 例 IV 期 NSCLC 患者（年龄 68±7 岁）。仅纳入肺腺癌患者。排除 ALK、ROS1、RET、MET、NTRK、EGFR、BRAF 突变患者。根据指南，患者接受 CPI 单药治疗（pembrolizumab、nivolumab、atezolizumab、cemiplimab）或 CIT（卡铂/培美曲塞/帕博利珠单抗、卡铂/紫杉醇/阿特珠单抗）治疗。我们登记了患者的特征，包括 TTF-1 表达。第 1 组包括 40 例 CPI 且 TTF-1 表达阳性的患者，第 2 组包括 26 例 CPI 且 TTF-1 表达阴性的患者。第 3 组包括 41 例 CIT 且 TTF-1 表达阳性的患者，第 4 组包括 23 例 CIT 且 TTF-1 表达阴性的患者。
结果
4 组患者的特征具有可比性。采用 cox 回归分析，我们发现与 CPI 且 TTF-1 表达阴性的患者相比，TTF-1 表达阳性的患者无进展生存期（PFS）更长（18±3 个月 vs. 5±0.85 个月，p=0.004，95%CI：0.23-0.984）。在接受 CIT 治疗的患者中，TTF-1 表达阳性患者的 PFS 也更长（9±3 个月 vs. 3±0.399 个月，p=0.001，95%CI：0.23-0.85）。
结论
在真实环境中，我们发现 TTF-1 表达与 PFS 增加相关。在肺腺癌患者中，TTF-1 表达与化疗/免疫治疗和免疫治疗的反应改善有关。
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