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在黑色素瘤中,治疗前的情绪困扰与新辅助免疫检查点阻塞反应之间的关联

Itske Fraterman¹, Irene L M Reijers², Petros Dimitriadis³

¹Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands.

Nature medicine

|November 13, 2023

概括

治疗前的情绪困扰 (ED) 与接受新辅助免疫检查点阻塞 (ICB) 的黑色素瘤患者的治疗结果较差有关. 这一发现表明ED可能是ICB治疗反应的关键生物标志物.

科学领域:

在瘤学瘤学.
免疫学免疫学免疫学
心理神经免疫学心理神经免疫学

背景情况:

新辅助免疫检查点阻断 (ICB) 显示出对IIIB-D阶段黑色素瘤的前景.
现有的生物标志物如干扰素- (IFNγ) 签名和瘤突变负担 (TMB) 有局限性.
临床前数据表明,情绪焦虑 (ED) 可以损害抗瘤免疫力.

研究的目的:

在IIIB-D阶段的黑色素瘤患者中调查治疗前ED和新辅助ICB的临床反应之间的关联.
探索ED作为ICB治疗的潜在预测生物标志物.

主要方法:

对第二阶段PRADO试验 (NCT02977052) 的后期分析.
使用欧洲癌症研究和治疗组织规模评估治疗前ED.
与主要病理反应,无复发存活率和远程转移无存活率相关的ED状态,调整为IFNγ签名和TMB.

主要成果:

治疗前ED患者显著减少了主要病理反应 (46%vs65%).
治疗前的ED与2年无复发存活率 (74%对91%) 和远程无转移存活率 (78%对95%) 的降低有关.
RNA测序没有揭示明确的β-上腺体或葡萄糖皮质激素机制,将ED与减少的结果联系起来.

结论:

治疗前的情绪困扰可能成为黑色素瘤中新辅助性ICB的负预后标志物.
需要进一步的研究来验证ED作为生物标志物,并了解潜在的机制.
情绪功能评估可能会对接受ICB的黑色素瘤患者的治疗策略进行改进.

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