Zheng Cheng-Wan, Yang Yun-Mo, Yang Hui
Department of Thyroid Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China.
World J Gastrointest Oncol. 2024 Sep 15;16(9):3905-3912. doi: 10.4251/wjgo.v16.i9.3905.
Advanced gastric cancer (AGC) remains a challenging malignancy with poor prognosis. The combination of oxaliplatin and trastuzumab has shown promising results in AGC treatment. This study aimed to investigate the effects of oxaliplatin and trastuzumab combination therapy on serum tumor markers and T lymphocyte subsets in patients with AGC and to explore their potential as predictive biomarkers for treatment response.
To investigate the impact of oxaliplatin and trastuzumab combination therapy on serum markers and T cell subsets in patients with AGC.
This prospective study enrolled 60 patients with AGC. All patients received oxaliplatin (130 mg/m, every 3 weeks) and trastuzumab (8 mg/kg loading dose, followed by 6 mg/kg every 3 weeks) for six cycles. Serum carcinoembryonic antigen (CEA), cancer antigen 19-9 (CA19-9), and cancer antigen 72-4 (CA72-4) were measured before and after treatment. T-lymphocyte subsets, including CD3+, CD4+, CD8+, and CD4+ /CD8+ ratios, were also evaluated. The clinical response was assessed using the Response Evaluation Criteria in Solid Tumors version 1.1.
After six cycles of treatment, the CEA, CA19-9, and CA72-4 serum levels significantly decreased compared to baseline levels ( < 0.001). The percentages of CD3+ and CD4+ T lymphocytes increased significantly ( < 0.05), whereas the percentage of CD8+ T lymphocytes decreased ( < 0.05). The CD4+/CD8+ ratio also significantly increased after treatment ( < 0.05). Patients with a higher decrease in serum tumor markers (≥ 50% reduction) and a higher increase in CD4+/CD8+ ratio (≥ 1.5-fold) showed better clinical response rates ( < 0.05).
Oxaliplatin and trastuzumab combination therapy effectively reduced serum tumor marker levels and modulated T lymphocyte subsets in patients with AGC. Combination therapy not only has a direct antitumor effect, but also enhances the immune response in patients with AGC. Serum tumor markers and T lymphocyte subsets may serve as potential predictive biomarkers for treatment response in patients with AGC receiving combination therapy.
晚期胃癌（AGC）仍然是一种具有挑战性的恶性肿瘤，预后较差。奥沙利铂和曲妥珠单抗联合使用在AGC治疗中已显示出有前景的结果。本研究旨在探讨奥沙利铂和曲妥珠单抗联合治疗对AGC患者血清肿瘤标志物和T淋巴细胞亚群的影响，并探索它们作为治疗反应预测生物标志物的潜力。
研究奥沙利铂和曲妥珠单抗联合治疗对AGC患者血清标志物和T细胞亚群的影响。
这项前瞻性研究纳入了60例AGC患者。所有患者接受奥沙利铂（130mg/m²，每3周一次）和曲妥珠单抗（8mg/kg负荷剂量，随后每3周6mg/kg），共六个周期。在治疗前后测量血清癌胚抗原（CEA）、癌抗原19-9（CA19-9）和癌抗原72-4（CA72-4）。还评估了T淋巴细胞亚群，包括CD3⁺、CD4⁺、CD8⁺以及CD4⁺/CD8⁺比值。使用实体瘤疗效评价标准1.1版评估临床反应。
经过六个周期的治疗，与基线水平相比，CEA、CA19-9和CA72-4的血清水平显著降低（P<0.001）。CD3⁺和CD4⁺T淋巴细胞的百分比显著增加（P<0.05），而CD8⁺T淋巴细胞的百分比降低（P<0.05）。治疗后CD4⁺/CD8⁺比值也显著增加（P<0.05）。血清肿瘤标志物下降幅度较大（≥50%降低）且CD4⁺/CD8⁺比值升高幅度较大（≥1.5倍）的患者显示出更好的临床反应率（P<0.05）。
奥沙利铂和曲妥珠单抗联合治疗有效降低了AGC患者的血清肿瘤标志物水平，并调节了T淋巴细胞亚群。联合治疗不仅具有直接的抗肿瘤作用，还增强了AGC患者的免疫反应。血清肿瘤标志物和T淋巴细胞亚群可能作为接受联合治疗的AGC患者治疗反应的潜在预测生物标志物。
