Ozbay Mehmet Fatih, Cetinkaya Aysegul Merc, Balcik Onur Yazdan, Ilhan Yusuf, Genc Tugrul Burak, Goksu Sema Sezgin
Department of Medical Oncology, Kirsehir Training and Research Hospital Kirsehir 40100, Turkey.
Department of Medical Oncology, Faculty of Medicine, Akdeniz University Antalya 07000, Turkiye.
Am J Cancer Res. 2024 Oct 25;14(10):5095-5104. doi: 10.62347/KRTH2276. eCollection 2024.
Lung cancer is the leading cause of cancer-related death globally and is often diagnosed at an advanced stage. Nivolumab represents a significant advancement for treating advanced non-small cell lung cancer (NSCLC). However, the absence of reliable biomarkers predicting treatment response hinders personalized therapy. Eosinophils play a notable role in cancer biology, particularly when treated with immune checkpoint inhibitors. Eosinophils can infiltrate tumor tissues, directly interacting with tumor cells or modifying the tumor microenvironment. This study aims to assess the potential of PD-L1 expression and peripheral blood eosinophil count in predicting treatment response and patient survival. This retrospective cohort study was conducted in three major cancer centers in Turkey, including 174 advanced NSCLC patients who had progressed after chemotherapy between July 2019 and November 2023. Demographic and clinical data, PD-L1 levels, and eosinophil counts were analyzed using SPSS 27.0. Survival analyses were performed with Kaplan-Meier and Cox regression models. Increased peripheral blood eosinophil count was positively associated with response to Nivolumab treatment and overall survival. Among treatment responders, 54.1% had eosinophil levels between 100-499 cells/mm before treatment, increasing to 70.8% post-treatment. In patients with high PD-L1 positivity (>50%), eosinophil levels averaged 266.0 cells/mm, with improved survival outcomes (mean survival: 24.06 months, median: 20.0 months). Non-responders had a mean survival of 19.05 months and a median survival of 15.2 months. Peripheral eosinophil count appears to be a potential biomarker for predicting response to Nivolumab treatment and survival in NSCLC patients. Combined evaluation of eosinophil count and PD-L1 expression may enhance personalized treatment strategies. Further validation in prospective, randomized studies is necessary.
肺癌是全球癌症相关死亡的主要原因，且常被诊断为晚期。纳武利尤单抗是治疗晚期非小细胞肺癌（NSCLC）的一项重大进展。然而，缺乏预测治疗反应的可靠生物标志物阻碍了个性化治疗。嗜酸性粒细胞在癌症生物学中发挥着显著作用，尤其是在接受免疫检查点抑制剂治疗时。嗜酸性粒细胞可浸润肿瘤组织，直接与肿瘤细胞相互作用或改变肿瘤微环境。本研究旨在评估PD-L1表达和外周血嗜酸性粒细胞计数在预测治疗反应和患者生存方面的潜力。这项回顾性队列研究在土耳其的三个主要癌症中心进行，纳入了174例在2019年7月至2023年11月期间化疗后病情进展的晚期NSCLC患者。使用SPSS 27.0分析人口统计学和临床数据、PD-L1水平及嗜酸性粒细胞计数。采用Kaplan-Meier法和Cox回归模型进行生存分析。外周血嗜酸性粒细胞计数增加与纳武利尤单抗治疗反应及总生存呈正相关。在治疗反应者中，54.1%在治疗前嗜酸性粒细胞水平为100 - 499个细胞/mm，治疗后增至70.8%。在PD-L1高阳性（>50%）的患者中，嗜酸性粒细胞水平平均为266.0个细胞/mm，生存结果改善（平均生存：24.06个月，中位数：20.0个月）。无反应者的平均生存为19.05个月，中位生存为15.2个月。外周嗜酸性粒细胞计数似乎是预测NSCLC患者对纳武利尤单抗治疗反应和生存的潜在生物标志物。联合评估嗜酸性粒细胞计数和PD-L1表达可能会增强个性化治疗策略。有必要在前瞻性随机研究中进一步验证。
