Okuji Takayuki, Iwama Shintaro, Kobayashi Tomoko, Yasuda Yoshinori, Ito Masaaki, Yamagami Ayana, Ando Masahiko, Hase Tetsunari, Shibata Hirofumi, Hatta Takahiro, Zhou Xin, Onoue Takeshi, Kawaguchi Yohei, Miyata Takashi, Sugiyama Mariko, Hagiwara Daisuke, Suga Hidetaka, Banno Ryoichi, Ando Yuichi, Hashimoto Naozumi, Arima Hiroshi
Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan.
Nagoya J Med Sci. 2024 Aug;86(3):452-463. doi: 10.18999/nagjms.86.3.452.
The presence of anti-thyroid antibodies (ATAs) is a biomarker for the development of thyroid dysfunction induced by anti-programmed cell death-1 antibodies (PD-1-Abs). While patients with thyroid dysfunction reportedly showed better overall survival (OS), it remains unknown if ATAs at baseline can predict OS. Therefore, in this study, we examined the association of ATAs at baseline with OS in non-small cell lung cancer (NSCLC) patients with different levels of programmed cell death-1 ligand 1 (PD-L1) positivity associated with PD-1-Ab treatment efficacy. A total of 81 NSCLC patients treated with PD-1-Abs were evaluated for ATAs at baseline and prospectively for OS. Among the 81 patients, 49 and 32 patients had ≥50% (group A) and <50% (group B) PD-L1 positivity, respectively. Median OS did not differ significantly between patients with (n = 13) and without (n = 36) ATAs at baseline in group A. In contrast, median OS was significantly longer in patients with (n = 10) versus without (n = 22) ATAs at baseline in group B (not reached vs 378 days, respectively; 95% CI, 182 to 574 days, = 0.049). These findings suggest that the presence of ATAs at baseline is a biomarker to predict better treatment efficacy of PD-1-Abs in NSCLC patients with low PD-L1 positivity, while the difference in OS in those with high PD-L1 positivity may be masked by increased tumor expression of PD-L1.
抗甲状腺抗体（ATA）的存在是抗程序性细胞死亡蛋白1抗体（PD - 1抗体）诱导的甲状腺功能障碍发生的生物标志物。虽然据报道甲状腺功能障碍患者的总生存期（OS）较好，但基线时的ATA是否能预测OS仍不清楚。因此，在本研究中，我们检查了基线时ATA与不同水平程序性细胞死亡蛋白1配体1（PD - L1）阳性的非小细胞肺癌（NSCLC）患者OS的相关性，这些患者接受PD - 1抗体治疗，PD - L1阳性水平与治疗疗效相关。共评估了81例接受PD - 1抗体治疗的NSCLC患者的基线ATA，并对其OS进行前瞻性研究。在这81例患者中，49例和32例患者的PD - L1阳性率分别≥50%（A组）和<50%（B组）。A组中，基线时有（n = 13）和无（n = 36）ATA的患者中位OS无显著差异。相比之下，B组中基线时有（n = 10）和无（n = 22）ATA的患者中位OS显著更长（分别为未达到和378天；95%CI，182至574天，P = 0.049）。这些发现表明，基线时ATA的存在是预测PD - L1阳性率低的NSCLC患者中PD - 1抗体治疗疗效更好的生物标志物，而PD - L1阳性率高的患者中OS的差异可能被PD - L1肿瘤表达增加所掩盖。
