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肥胖和免疫检查点抑制后的存活率,用于头部和部状细胞癌

Eric V Mastrolonardo¹, Pablo Llerena¹, Joseph Lu¹

¹Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania.

JAMA otolaryngology-- head & neck surgery

|July 3, 2024

概括

接受免疫检查点抑制剂 (ICI) 治疗的头癌患者的肥胖与更好的生存率和更少需要食或呼吸管相关. 这一发现表明,在这个患者群体中,更高的体重指数 (BMI) 有潜在的益处.

科学领域:

在瘤学瘤学.
免疫治疗是一种免疫疗法.
癌症流行病学癌症流行病学

背景情况:

免疫检查点抑制剂 (ICI) 在各种癌症中改善了生存率.
肥胖对ICI结果的影响越来越被认可,但头部和部状细胞癌 (HNSCC) 的数据有限.
了解影响ICI疗效的因素对于优化癌症治疗至关重要.

研究的目的:

根据治疗前的身体质量指数 (BMI) 进行ICI治疗的HNSCC患者的整体生存 (OS) 和功能结果比较.
调查正常BMI与肥胖BMI以及长期生存和功能状态之间的关联.
探索BMI在接受免疫治疗的HNSCC患者预测结果中的作用.

主要方法:

使用 TriNetX 全球协作网络进行的以人口为基础的回顾性队列研究.
鉴定了166名接受ICI治疗的HNSCC患者 (2012-2023年),通过倾向性得分匹配,与BMI (正常与肥胖) 相匹配.
在BMI组之间比较了5年的生存状况和功能结果 (食障碍,气管支架,胃口支架依赖).

主要成果:

肥胖BMI与正常BMI相比,在6个月,3年和5年内显著改善了OS.
患有肥胖BMI的患者在所有测量时间点 (6个月至5年) 中,胃口管依赖的风险降低.
肥胖BMI也与治疗后1,3年和5年的气管切除术依赖性风险降低相关.

结论:

接受ICI治疗的HNSCC患者的肥胖与改善整体存活率和减少对支持性护理的依赖性有关.
这些发现表明肥胖患者的潜在生存优势,需要进一步的机制性研究.
这项研究强调了在HNSCC中,宿主因素 (如BMI) 和对免疫治疗的反应之间的复杂相互作用.

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