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在免疫检查点抑制剂时代的晚期癌中与年龄相关的生存差异使用SEER数据库和元分析

Abdullah Al-Danakh^1,2, Yuli Jian³, Linlin Yang⁴

¹Department of Urology, First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China. aldanekh2017@gmail.com.

Scientific reports

|December 3, 2025

概括

与老年患者相比,免疫检查点抑制剂 (ICI) 对较年轻的晚期细胞癌 (aRCC) 患者的生存益处更大. 与TNFSF15表达的年龄相关的差异可能解释了这些对ICI治疗的不同反应.

科学领域:

在瘤学瘤学.
免疫学免疫学免疫学
老年学是一门学科.

背景情况:

免疫衰退,即与年龄相关的免疫系统衰退,可以降低免疫检查点抑制剂 (ICI) 在癌症治疗中的有效性.
虽然ICI疗法为晚期细胞癌 (aRCC) 提供了生存优势,但其在不同年龄人口统计学中的有效性尚不清楚.

研究的目的:

为了调查与晚期细胞癌 (aRCC) 患者的生存结果的年龄相关差异,这些患者接受了免疫检查点抑制剂 (ICI) 治疗.
探索潜在的分子机制,如TNFSF15表达,这可能有助于对ICI治疗的年龄依赖反应.

主要方法:

来自监测,流行病学和最终结果 (SEER) 计划 (2004-2021) 的综合队列的分析以及随机对照试验 (RCT) 的元分析.
用Kaplan-Meier曲线和Cox回归来进行生存分析,将患者分为年轻 (<65岁) 和老 (≥65岁) 组.
与年龄和治疗反应相关的TNFSF15表达的免疫组织化学 (IHC) 分析.

主要成果:

在ICI时代,较年轻的aRCC患者 (<65岁) 与老年患者 (≥65岁) 相比,在ICI时代表现出明显优于整体存活率 (OS).
分析证实ICI对年轻患者的生存率有所改善,而老年患者的益处较小.
TNFSF15表达与年龄负相关,在年轻患者中观察到更高的水平,这表明在差异性ICI疗效中可能发挥作用.

结论:

免疫检查点抑制剂 (ICI) 在晚期细胞癌 (aRCC) 的年轻患者中更有效,这凸显了需要年龄分层治疗策略的需要.
在aRCC中,TNFSF15的年龄依赖表达可能是ICI治疗对治疗反应观察到的变异的基础.

关键词:

晚期的细胞癌.年龄特定的生存率.免疫检查点抑制剂免疫检查点抑制剂进行元分析分析.塞尔·塞尔 (Seer) 是一个看得见的人.在TNFSF15中,

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