瘤免疫微环境和第四阶段泌尿器癌的临床结果:YODO研究
Hiroyuki Nishiyama1, Toyonori Tsuzuki2, Chikara Ohyama3
1Department of Urology, University of Tsukuba, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan.
International journal of clinical oncology
|July 27, 2023
概括
在日本患有转移性尿路细胞癌的患者中,编程死亡配体1 (PD-L1) 表达和瘤突变负担 (TMB) 不能预测预后. 然而,癌症免疫表型可能是顺序化疗和免疫检查点抑制剂 (ICI) 治疗的关键预后因素.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
背景情况:
- 全球膀癌发病率正在上升,特别是在日本.
- 通过识别化疗和免疫检查点抑制剂 (ICI) 反应的生物标志物,可以优化转移性尿路细胞癌 (mUC) 治疗.
- 预测性生物标志物对于在mUC中量身定制顺序治疗策略至关重要.
研究的目的:
- 评估编程死亡配体1 (PD-L1) 表达,瘤突变负担 (TMB) 和癌症免疫表型作为日本患者的预测性预后生物标志物.
- 评估PD-L1表达的患病率及其与治疗结果的相关性.
- 探索 TMB 和癌症免疫表型的预后价值,在接受顺序第一和第二线治疗的患者中.
主要方法:
- 一项多中心,回顾性队列研究,对143名日本成人患者进行了mUC.
- 分析PD-L1表达,非同义词TMB和癌症免疫表型 (免疫沙漠,免疫排除,炎症).
- 评估一线和二线治疗后的总生存 (OS) 和无进展生存 (PFS).
主要成果:
- 在29.4%的患者中观察到高PD-L1表达;高TMB在33.6%.
- 癌症免疫表型包括免疫沙漠 (62.9%),免疫排除 (30.8%) 和炎症 (6.3%).
- PD-L1表达和TMB不是OS或PFS的显著预测因素;免疫排除的表型显示出比免疫沙漠更好的OS.
结论:
- 在日本一线治疗后的mUC患者中,PD-L1表达和TMB不是显著的预后预测因素.
- 癌症免疫表型可以作为优化顺序化疗-ICI策略的关键预后因素.
- 对癌症免疫表型的进一步研究可能会改进对mUC的治疗决策.
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