基线葡萄糖与淋巴细胞的比率预测了nivolumab在晚期非小细胞肺癌中的结果:一个多中心的回顾性研究
Mustafa Ersoy1, Umut Kefeli2, Devrim Cabuk2
1Department of Internal Medicine, Division of Medical Oncology, Kutahya Health Sciences University, Kutahya, Türkiye.
Frontiers in immunology
|March 2, 2026
概括
葡萄糖与淋巴细胞比率 (GLR) 可以预测接受PD-1封锁的非小细胞肺癌 (NSCLC) 患者的生存率. 较低的GLR表明尼沃卢马布治疗NSCLC患者的整体存活率 (OS) 和无进展存活率 (PFS) 更好.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 生物标志物 生物标志物
背景情况:
- 在非小细胞肺癌 (NSCLC) 中指导免疫治疗的生物标志物有限.
- 葡萄糖与淋巴细胞比率 (GLR),结合新陈代谢和免疫状态,在各种癌症中显示出预后价值.
- 在接受PD-1阻塞治疗的患者中,GLR尚未被系统评估.
研究的目的:
- 为了评估基线葡萄糖与淋巴细胞比率 (GLR) 的预后值,治疗nivolumab的晚期或转移性非小细胞肺癌 (NSCLC) 患者.
- 确定最佳的GLR切断值来预测整体存活率 (OS) 和无进展存活率 (PFS).
主要方法:
- 对837名用nivolumab治疗的晚期/转移性NSCLC患者的回顾性分析.
- 从禁食葡萄糖和绝对淋巴细胞计数计算基线GLR.
- 对于OS和PFS的卡普兰-梅尔分析,用于比较的日志级别测试,以及用于预测的多变量考克斯回归. ROC分析确定了最佳的GLR切线.
主要成果:
- 对于死亡率,确定了≥70.76的最佳GLR切断值 (AUC = 0.635).
- 与GLR≥70.76 (p<0.001) 患者相比,GLR<70.76的患者的生存期 (24.1个月与9.6个月) 和PFS (9.7个月与5.8个月) 显著更长,比GLR≥70.76 (p<0.001) 的患者要长.
- 较高的GLR和较差的ECOG性能状态是较差的OS的独立预测因素;之前的胸部放射治疗与改善的结果有关.
结论:
- 基线GLR是一种实用,具有成本效益的生物标志物,可在接受尼沃卢马布的高级NSCLC患者中独立预测OS.
- 升高的GLR可能表明代谢功能障碍和免疫储备受损,不利于PD-1阻断的有效性.
- 需要进行前性研究来验证GLR并确定其临床效用.
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