Ueda Natsuko, Kuroki Masashi, Shibata Hirofumi, Matsubara Manato, Akita Saki, Yamada Tatsuhiko, Kato Rina, Iinuma Ryota, Kawaura Ryo, Okuda Hiroshi, Terazawa Kosuke, Mori Kenichi, Saijo Ken, Ohashi Toshimitsu, Ogawa Takenori
Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Gifu University, Gifu 501-1194, Japan.
Department of Clinical Oncology, Graduate School of Medicine, Tohoku University, Sendai 980-8576, Japan.
Cancers (Basel). 2024 Dec 3;16(23):4056. doi: 10.3390/cancers16234056.
Previously, we proposed that the immune-modified Glasgow Prognostic Score (imGPS), which adds the lymphocyte count to the mGPS, is helpful as a prognostic marker for patients with head and neck squamous cell carcinoma. In this study, we investigated the imGPS as a marker for the therapeutic effect of pembrolizumab in treating recurrent and metastatic head and neck cancer (RMHNC).
This study included RMHNC patients who were treated with pembrolizumab from December 2019 to April 2024. ALB, CRP, lymphocyte counts, neutrophil-to-lymphocyte ratios (NLRs), mGPSs, and imGPSs were extracted as biomarkers, and the response rate and prognosis were analyzed for each.
A total of 54 patients were enrolled. Lymphocyte counts were correlated with the overall response rates (ORRs) ( = 0.0082). Although the mGPS did not show significant differences in ORRs, imGPSs revealed a significant difference ( = 0.013). CRP, ALB, and lymphocyte counts were correlated with overall survival (OS) and/or progression-free survival (PFS). NLRs, mGPSs, and imGPSs were also correlated with OS and/or PFS, with imGPSs showing the greatest area under the curve (OS; AUC = 0.795, PFS; AUC = 0.754).
This study demonstrates that the imGPS is an excellent predictive marker for the therapeutic effect and prognosis of pembrolizumab for RMHNC. The imGPS can be employed with daily blood tests, highlighting the potential to forecast the impact of the ICI with high reliability.
此前，我们提出免疫修正的格拉斯哥预后评分（imGPS），即在改良格拉斯哥预后评分（mGPS）基础上增加淋巴细胞计数，对头颈鳞状细胞癌患者是一种有用的预后标志物。在本研究中，我们调查了imGPS作为帕博利珠单抗治疗复发和转移性头颈癌（RMHNC）疗效的标志物。
本研究纳入了2019年12月至2024年4月接受帕博利珠单抗治疗的RMHNC患者。提取白蛋白（ALB）、C反应蛋白（CRP）、淋巴细胞计数、中性粒细胞与淋巴细胞比值（NLR）、mGPS和imGPS作为生物标志物，并分别分析其缓解率和预后情况。
共纳入54例患者。淋巴细胞计数与总缓解率（ORR）相关（ = 0.0082）。虽然mGPS在ORR方面未显示出显著差异，但imGPS显示出显著差异（ = 0.013）。CRP、ALB和淋巴细胞计数与总生存期（OS）和/或无进展生存期（PFS）相关。NLR、mGPS和imGPS也与OS和/或PFS相关，其中imGPS的曲线下面积最大（OS；AUC = 0.795，PFS；AUC = 0.754）。
本研究表明，imGPS是帕博利珠单抗治疗RMHNC疗效和预后的优秀预测标志物。imGPS可用于日常血液检测，凸显了以高可靠性预测免疫检查点抑制剂影响的潜力。
