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基于淋巴细胞子集的非侵入性生物标志物预测了EGFR-TKI预先治疗的EGFR突变NSCLC的免疫化疗效果

Lianxi Song^1,2,3, Liang Zeng¹, Qinqin Xu⁴

¹Department of Medical Oncology, Lung Cancer and Gastrointestinal Unit, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, China.

|August 20, 2025

概括

结合免疫检查点抑制剂 (化疗+ICI) 的化疗对EGFR突变非小细胞肺癌患者具有显著的益处. 一个新的淋巴细胞子集模型 (LSM) 可以预测患者对这种联合治疗的反应.

科学领域:

癌症学
免疫疗法
基因组学

背景情况:

皮肤生长因子受体 (EGFR) 突变非小细胞肺癌 (NSCLC) 经常对氨酸激酶抑制剂 (TKIs) 产生耐药性.
结合化疗与免疫检查点抑制剂 (ICI) 的疗效在这种耐TCI群体中是可变的.
需要预测生物标志物来确定可能受益于化疗+ICI治疗的患者.

研究的目的:

在EGFR突变NSCLCTKI后进展中,评估化疗+ICI与单独化疗的治疗结果.
开发和验证淋巴细胞子集模型 (LSM) 以预测该患者群的生存结果.
评估LSM在识别可能受益于化疗+ICI患者方面的潜力.

主要方法:

在TKI治疗后进展的EGFR突变NSCLC患者的回顾性分析.
用化疗+ICI治疗和单独化疗治疗的患者之间的结果比较.
使用治疗前血液样本预测存活率的淋巴细胞子集模型 (LSM) 的开发.

主要成果:

与单独化疗相比,化疗+ICI显著改善了整体反应率 (34. 2% 与 22. 0%),无进展生存率 (6. 0 与 4. 0 个月) 和整体生存率 (14. 6 与 11. 0 个月).
开发的LSM显示出良好的预测性能 (AUC为0.726,灵敏度为58.6%,特异性为83.8%).
在训练和验证队列中,被归类为高LSM的患者比LSM低的患者的无进展生存时间显著长.

结论:

对于EGFR-TKI耐药EGFR突变NSCLC患者来说,化疗+ICI具有显著的生存益处.
淋巴细胞子集模型 (LSM) 是一个有希望的预测工具,用于确定最有可能从化疗+ICI中受益的患者.
这些发现支持在这种特定的NSCLC群体中使用化疗+ICI,并突出了LSM的潜在临床效用.

关键词:

卫生科学内部医学医疗专业医学癌症学

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