血清镁水平升高可改善接受免疫检查点抑制剂治疗的癌症患者的预后。

Elevated serum magnesium levels prompt favourable outcomes in cancer patients treated with immune checkpoint blockers.

机构信息

State Key Laboratory of Druggability Evaluation and Systematic Translational Medicine / Department of Lymphoma, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, the Sino-US Center for Lymphoma and Leukemia Research, Tianjin 300060, China.

出版信息

Eur J Cancer. 2024 Dec;213:115069. doi: 10.1016/j.ejca.2024.115069. Epub 2024 Oct 11.

DOI:10.1016/j.ejca.2024.115069

PMID:39489925

Abstract

BACKGROUND

Magnesium deficiency influences the activation and cytotoxicity of immune cells. Nevertheless, whether serum magnesium levels influence the clinical outcomes of immune checkpoint blockers (ICBs) treatment still remains ambiguous. There is an urgent need for clinical research to elucidate the relationship between serum magnesium levels and the outcomes of ICB therapy. Such insights could offer new perspectives on immunotherapy for cancer.

METHODS

A multi-center retrospective study involving in pan-cancer patients treated with ICBs at three large cancer centers from August 2012 to May 2023 was conducted. The primary objective was to assess the correlation between serum magnesium levels and therapeutic response in patients receiving ICBs, and further evaluate the associations between serum magnesium levels and progression-free survival (PFS) and overall survival (OS).

RESULTS

A total of 1441 patients treated with ICBs, including 1042 with lung cancer, 270 with esophageal cancer, and 129 with Hodgkin lymphoma, were enrolled in this study. We found that patients with elevated serum magnesium levels exhibited a favourable response to ICBs treatment. The optimal cut-off point for serum magnesium level (0.79 mmol/L) was applied for stratifying patients into distinct groups. In the three tumor cohorts, patients in high magnesium level group (Mg ≥ 0.79 mmol/L) had longer PFS and OS than those in low magnesium level group (Mg < 0.79 mmol/L). Univariate and multivariate analyses confirmed that the serum Mg level serves as an independent prognostic factor for cancer patients receiving ICBs therapy.

CONCLUSION

Our multi-center study demonstrated that among patients receiving ICBs therapy, those with elevated serum magnesium levels exhibit significantly better clinical outcomes than those with low serum magnesium levels. Further prospective validation studies are needed to confirm these findings.

摘要

背景

镁缺乏会影响免疫细胞的激活和细胞毒性。然而，血清镁水平是否影响免疫检查点抑制剂（ICB）治疗的临床结局仍不清楚。迫切需要临床研究来阐明血清镁水平与 ICB 治疗结局之间的关系。这些见解可为癌症的免疫治疗提供新视角。

方法

对 2012 年 8 月至 2023 年 5 月在三家大型癌症中心接受 ICB 治疗的泛癌患者进行了一项多中心回顾性研究。主要目的是评估血清镁水平与接受 ICB 治疗的患者治疗反应之间的相关性，并进一步评估血清镁水平与无进展生存期（PFS）和总生存期（OS）之间的关联。

结果

共纳入 1441 例接受 ICB 治疗的患者，其中肺癌 1042 例，食管癌 270 例，霍奇金淋巴瘤 129 例。我们发现，血清镁水平升高的患者对 ICB 治疗有良好的反应。血清镁水平的最佳截断值（0.79mmol/L）用于将患者分为不同组。在三个肿瘤队列中，高镁水平组（Mg≥0.79mmol/L）的患者 PFS 和 OS 均长于低镁水平组（Mg＜0.79mmol/L）。单因素和多因素分析证实，血清 Mg 水平是接受 ICB 治疗的癌症患者的独立预后因素。