Xu Junzhu, Wang Haitao, Zhang Chi, Jin Su-Han, Chen Xiaofei, Tan Fangya, Frey Benjamin, Hecht Markus, Sun Jian-Guo, Gaipl Udo S, Ma Hu, Zhou Jian-Guo
Department of Oncology, The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563000, P.R. China.
Thoracic Surgery Branch, Center for Cancer Research, NCI, NIH, Bethesda, MD 20892, USA.
iScience. 2024 Nov 8;27(12):111363. doi: 10.1016/j.isci.2024.111363. eCollection 2024 Dec 20.
Radiotherapy showed synergy with immunotherapy, yet the comparative effectiveness of combining immunotherapy (iRT) or chemotherapy (CRT) after platinum therapy failure in advanced non-small cell lung cancer (NSCLC) remains unexplored. We analyzed 163 patients (iRT: = 120 vs. CRT: = 43) eligible for combination radiotherapy. Before matching, median overall survival (OS) was significantly longer in iRT group (7.79 vs. 4.57 months, hazard ratio [HR]: 0.62, 95% confidence interval [CI]: 0.41-0.94, = 0.024). After 1:2 propensity score matching (PSM) and inverse probability of treatment weighting (IPTW), iRT group showed improved OS, consistent with unmatched analysis (PSM, = 0.033 and IPTW, = 0.035). Exploratory analysis suggested that PD1, central memory PD1, and effector memory PD-L1 CD4 T cells were strong predictive biomarkers for iRT-treated patients ( = 0.025, = 0.002, = 0.010, respectively). Proliferative CD4 T cell was a prognostic ( = 0.008) and predictive biomarker for iRT ( < 0.001). Our work revealed iRT was prolonged OS in previously treated advanced NSCLC patients. Additionally, proliferative CD4 T cell served as prognostic and predictive biomarkers.
放射治疗显示出与免疫治疗具有协同作用，但在晚期非小细胞肺癌（NSCLC）中，铂类治疗失败后联合免疫治疗（iRT）或化疗（CRT）的相对疗效仍未得到探索。我们分析了163例符合联合放疗条件的患者（iRT组：n = 120 vs. CRT组：n = 43）。在匹配前，iRT组的中位总生存期（OS）显著更长（7.79个月 vs. 4.57个月，风险比[HR]：0.62，95%置信区间[CI]：0.41 - 0.94，P = 0.024）。在进行1:2倾向评分匹配（PSM）和治疗逆概率加权（IPTW）后，iRT组的OS有所改善，与未匹配分析结果一致（PSM，P = 0.033；IPTW，P = 0.035）。探索性分析表明，PD1、中央记忆性PD1和效应记忆性PD-L1 CD4 T细胞是接受iRT治疗患者的强预测生物标志物（分别为P = 0.025、P = 0.002、P = 0.010）。增殖性CD4 T细胞是iRT的预后生物标志物（P = 0.008）和预测生物标志物（P < 0.001）。我们的研究表明，iRT可延长先前接受治疗的晚期NSCLC患者的OS。此外，增殖性CD4 T细胞可作为预后和预测生物标志物。
