The association between acupuncture and response to immune checkpoint inhibitors in non-small cell lung cancer.

IF 5.7 3区医学 Q1 INTEGRATIVE & COMPLEMENTARY MEDICINE

Chinese Medicine Pub Date : 2025-09-19 DOI:10.1186/s13020-025-01148-4

Rui Zhou, Yan-Juan Zhu, Yi-Han He, Jia-Jia Lin, Ze-Xin Zhang, Wen-Jie Zhao, Hao-Chuan Ma, Xue-Song Chang, Ya-Dong Chen, Wen-Zhu Li, Xian Chen, Xiao-Shu Chai, Hai-Bo Zhang

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引用次数: 0

Abstract

Background: Immune checkpoint inhibitors (ICIs) have transformed non-small cell lung cancer (NSCLC) treatment, yet low response rates and resistance remain challenges. Emerging evidence suggests acupuncture may enhance ICI effectiveness by reprogramming immunosuppressive tumor microenvironments.

Methods: A retrospective analysis was conducted on 217 ICI-treated NSCLC patients. Patients who initiated acupuncture before median progression-free survival (mPFS, 8.87 months) of the overall population were classified as the acupuncture group (n = 97). Cox regression analysis was employed to evaluate the association between clinical characteristics and outcomes. Propensity score matching (PSM) was performed to mitigate selection bias. Subgroup and interaction analyses were conducted to evaluate potential effect modifiers.

Results: Acupuncture was significantly associated with improved mPFS (10.23 vs. 7.87 months, P = 0.036), while a numerical trend favoring acupuncture was observed in overall survival (mOS: 24.1 vs. 20.9 months, P = 0.352). Obvious benefits emerged in bone metastasis patients, with the acupuncture group reducing progression risk by 76% (HR = 0.24, 95% CI 0.14-0.42, P < 0.001) and death risk by 53% (HR = 0.47, 95% CI 0.21-1.03, P = 0.049). Conversely, PD-L1-positive subgroups exhibited no trend of improvement (subgroup HR > 1.0), with interaction HRs > 2.0 indicating potential impairment of ICI efficacy. The results of post-PSM data suggest that acupuncture was independently associated with improved PFS (aHR = 0.62, 95% CI 0.41-0.94, P = 0.024).

Conclusion: Our findings suggest a positive association between acupuncture and improved outcomes in ICI-treated NSCLC patients, particularly in those with bone metastasis, underscoring the potential role of acupuncture in the integrative management of cancer. However, biomarker-guided patient stratification is essential for integrating acupuncture into oncology care.

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针刺与非小细胞肺癌免疫检查点抑制剂应答之间的关系。

背景：免疫检查点抑制剂（ICIs）已经改变了非小细胞肺癌（NSCLC）的治疗，但低有效率和耐药仍然是一个挑战。新出现的证据表明，针灸可以通过重新编程免疫抑制肿瘤微环境来提高ICI的有效性。方法：对217例经ici治疗的非小细胞肺癌患者进行回顾性分析。在总体人群的中位无进展生存期（mPFS， 8.87个月）之前开始针灸治疗的患者分为针灸组（n = 97）。采用Cox回归分析评价临床特征与结局的相关性。采用倾向得分匹配（PSM）来减轻选择偏差。通过亚组分析和相互作用分析来评价潜在的效果调节剂。结果：针刺与mPFS的改善显著相关（10.23 vs. 7.87个月，P = 0.036），而针刺在总生存期（mo: 24.1 vs. 20.9个月，P = 0.352）中表现出有利的数值趋势。骨转移患者获益明显，针刺组降低了76%的进展风险（HR = 0.24, 95% CI 0.14-0.42, P 1.0），相互作用HR bbb2.0表明ICI疗效可能受损。psm后数据结果显示，针灸与PFS改善独立相关（aHR = 0.62, 95% CI 0.41-0.94, P = 0.024）。结论：我们的研究结果表明，针灸与ici治疗的非小细胞肺癌患者的预后改善呈正相关，特别是那些有骨转移的患者，强调了针灸在癌症综合治疗中的潜在作用。然而，生物标志物引导的患者分层对于将针灸纳入肿瘤治疗至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Chinese Medicine INTEGRATIVE & COMPLEMENTARY MEDICINE-PHARMACOLOGY & PHARMACY

CiteScore

7.90

自引率

4.10%

发文量

133

审稿时长

31 weeks

期刊介绍： Chinese Medicine is an open access, online journal publishing evidence-based, scientifically justified, and ethical research into all aspects of Chinese medicine. Areas of interest include recent advances in herbal medicine, clinical nutrition, clinical diagnosis, acupuncture, pharmaceutics, biomedical sciences, epidemiology, education, informatics, sociology, and psychology that are relevant and significant to Chinese medicine. Examples of research approaches include biomedical experimentation, high-throughput technology, clinical trials, systematic reviews, meta-analysis, sampled surveys, simulation, data curation, statistics, omics, translational medicine, and integrative methodologies. Chinese Medicine is a credible channel to communicate unbiased scientific data, information, and knowledge in Chinese medicine among researchers, clinicians, academics, and students in Chinese medicine and other scientific disciplines of medicine.