Chen Xiaoqian, Li Wenkui, Lei Xiaogai, Li Zhanhong, Guo Qijing, Ma Xinfu, Luo Yushuang, Wang Liang
Department of Gastrointestinal Oncology Surgery, Affiliated Hospital of Qinghai University and Affiliated Cancer Hospital of Qinghai University, Xining, Qinghai, China.
Department of Emergency Medicine, The Second People's Hospital, Xining, Qinghai, China.
Front Oncol. 2024 Aug 12;14:1429095. doi: 10.3389/fonc.2024.1429095. eCollection 2024.
To investigate the effects of a PD-1 inhibitor combined with a bevacizumab monoclonal antibody on tumor immune cells in patients with first-line treatment failure in MSS/pMMR advanced colorectal cancer.
Control group consisted of 50 patients treated with the FOLFIRI combined with Bevacizumab regimen. The experimental group consisted of 60 patients treated with the Sintilimab combined with Bevacizumab regimen. By comparing the expression levels of CD8+ T lymphocytes, TAMs, and CAFs before and after treatment, short-term efficacy after treatment, and adverse drug reactions between the two groups, we comprehensively evaluated the impact of Sintilimab combined with Bevacizumab on patients with MSS/pMMR advanced colorectal cancer who failed first-line treatment.
There was a statistically significant difference in the percentage of CD8+ T lymphocytes, TAMs, and CAFs before and after treatment between the two groups (<0.05);Immunohistochemical scoring of CD8+ T lymphocytes, TAMs, and CAFs showed significant differences between the groups post-treatment ). The experimental group demonstrated statistically significant differences in immunohistochemical scoring of CD8+ T lymphocytes, TAMs, and CAFs before and after treatment (). There was a statistically significant difference in the therapeutic effect between the two groups of tumors (<0.05). The experimental group had greater PFS, mPFS, ORR, and DCR than did the control group. There was no statistically significant difference in the occurrence rate of drug-related adverse reactions after treatment between the two groups (>0.05). The results of the Cox proportional hazards model analysis indicate that age, gender, and group are independent risk factors affecting MSS/pMMR advanced colorectal cancer patients treated with second-line therapy in this study. Patients aged ≤60 years, male patients, and those in the experimental group showed better treatment responses in this study.
By administering immune checkpoint inhibitors in combination with bevacizumab to patients with advanced colorectal cancer with MSS/pMMR disease for whom first-line treatment failed, not only did the patients' prognosis improve, but the adverse drug reactions were also safe and controllable.
探讨程序性死亡受体1（PD-1）抑制剂联合贝伐单抗单克隆抗体对微卫星稳定/错配修复缺陷（MSS/pMMR）晚期结直肠癌一线治疗失败患者肿瘤免疫细胞的影响。
对照组由50例接受FOLFIRI方案联合贝伐单抗治疗的患者组成。实验组由60例接受信迪利单抗联合贝伐单抗方案治疗的患者组成。通过比较两组治疗前后CD8+T淋巴细胞、肿瘤相关巨噬细胞（TAMs）和癌相关成纤维细胞（CAFs）的表达水平、治疗后的短期疗效以及药物不良反应，我们全面评估了信迪利单抗联合贝伐单抗对一线治疗失败的MSS/pMMR晚期结直肠癌患者的影响。
两组治疗前后CD8+T淋巴细胞、TAMs和CAFs的百分比差异有统计学意义（<0.05）；CD8+T淋巴细胞、TAMs和CAFs的免疫组化评分在治疗后组间有显著差异。实验组治疗前后CD8+T淋巴细胞、TAMs和CAFs的免疫组化评分差异有统计学意义（）。两组肿瘤的治疗效果差异有统计学意义（<0.05）。实验组的无进展生存期（PFS）、中位无进展生存期（mPFS）、客观缓解率（ORR）和疾病控制率（DCR）均高于对照组。两组治疗后药物相关不良反应的发生率差异无统计学意义（>0.05）。Cox比例风险模型分析结果表明，年龄、性别和分组是影响本研究中接受二线治疗的MSS/pMMR晚期结直肠癌患者的独立危险因素。在本研究中，年龄≤60岁的患者、男性患者和实验组患者的治疗反应较好。
对于一线治疗失败的MSS/pMMR晚期结直肠癌患者，给予免疫检查点抑制剂联合贝伐单抗治疗，不仅改善了患者的预后，而且药物不良反应安全可控。
