预测晚期胃癌免疫疗法疗效的肿瘤微环境 RNA 检测:TIMES001 试验。

IF 12.8 Q1 MEDICINE, RESEARCH & EXPERIMENTAL
Med Pub Date : 2024-11-08 Epub Date: 2024-07-31 DOI:10.1016/j.medj.2024.07.006
Min Shi, Dongqiang Zeng, Huiyan Luo, Jian Xiao, Yongqiang Li, Xia Yuan, Na Huang, Jiani Wu, Siting Zheng, Jianhua Wu, Shaowei Li, Xiaoxiang Rong, Chunlin Wang, Luyang Jiang, Qianqian Mao, Wenjun Qiu, Jian Guo, Qiong Deng, Huiying Sun, Xiansheng Lu, Yunfang Yu, Yonghong Lai, Yiran Fang, Rui Zhou, Ling Wang, Xiatong Huang, Yuyun Kong, Jun Li, Li Liang, Jianping Bin, Yulin Liao, Wangjun Liao
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引用次数: 0

摘要

背景:临床试验支持免疫检查点阻断剂(ICBs)加化疗对部分转移性胃癌(mGC)患者的疗效。为了确定反应的决定因素,我们开发了一个TMEscore模型来评估肿瘤微环境(TME),TME之前已被证明是ICBs的生物标志物:方法:利用包含 30 个 TME 基因的 PCR 检测试剂盒建立了 TMEscore 检测参考数据库。这项多中心前瞻性临床试验(NCT#04850716)纳入了接受ICB联合化疗作为一线治疗方案的mGC患者。治疗前从五个医疗中心提取的86份肿瘤样本用于估算TME评分、PD-L1(CPS)和错配修复缺陷:研究结果:组群的客观反应率(ORR)和中位生存期分别为31.4%和6个月。在TME评分高的mGC患者中观察到更高的ORR(ORR=59%)。生存分析表明,高TME评分与更有利的PFS和OS显著相关。此外,研究还发现,TMEscore是一种预测性生物标志物,其预测性超过了MSI和CPS(AUC分别为0.873、0.511和0.524)。通过整合 TMEscore 和临床变量,融合模型进一步提高了预测效率和在临床环境中的转化应用:这项前瞻性临床研究表明,TMEscore检测是筛选mGC患者的可靠生物标志物,这些患者可能从ICB加化疗中获益:广东省基础与应用基础研究基金(2023A1515011214)、广州市科技计划项目(202206080011)、广州市科技计划项目(2023A03J0722和2023A04J2357)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Tumor microenvironment RNA test to predict immunotherapy outcomes in advanced gastric cancer: The TIMES001 trial.

Background: Clinical trials support the efficacy of immune checkpoint blockades (ICBs) plus chemotherapy in a subset of patients with metastatic gastric cancer (mGC). To identify the determinants of response, we developed a TMEscore model to assess tumor microenvironment (TME), which was previously proven to be a biomarker for ICBs.

Methods: A reference database of TMEscore assays was established using PCR assay kits containing 30 TME genes. This multi-center prospective clinical trial (NCT#04850716) included patients with mGC who were administered ICB combined with chemotherapy as a first-line regimen. Eighty-six tumor samples extracted from five medical centers before treatment were used to estimate the TMEscore, PD-L1 (CPS), and mismatch repair deficiency.

Findings: The objective response rate (ORR) and median PFS of the cohort were 31.4% and six months. Enhanced ORR was observed in TMEscore-high mGC patients (ORR = 59%). The survival analysis demonstrated that high TMEscore was significantly associated with a more favorable PFS and OS. Moreover, TMEscore was found to be a predictive biomarker that surpassed MSI and CPS (AUC = 0.873, 0.511, and 0.524, respectively). By integrating the TMEscore and clinical variables, the fused model further enhances the predictive efficiency and translational application in a clinical setting.

Conclusions: This prospective clinical study indicates that the TMEscore assay is a robust biomarker for screening patients with mGC who may derive survival benefits from ICB plus chemotherapy.

Funding: Guangdong Basic and Applied Basic Research Foundation (2023A1515011214), Science and Technology Program of Guangzhou (202206080011), and Guangzhou Science and Technology Project (2023A03J0722 and 2023A04J2357).

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来源期刊
Med
Med MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
17.70
自引率
0.60%
发文量
102
期刊介绍: Med is a flagship medical journal published monthly by Cell Press, the global publisher of trusted and authoritative science journals including Cell, Cancer Cell, and Cell Reports Medicine. Our mission is to advance clinical research and practice by providing a communication forum for the publication of clinical trial results, innovative observations from longitudinal cohorts, and pioneering discoveries about disease mechanisms. The journal also encourages thought-leadership discussions among biomedical researchers, physicians, and other health scientists and stakeholders. Our goal is to improve health worldwide sustainably and ethically. Med publishes rigorously vetted original research and cutting-edge review and perspective articles on critical health issues globally and regionally. Our research section covers clinical case reports, first-in-human studies, large-scale clinical trials, population-based studies, as well as translational research work with the potential to change the course of medical research and improve clinical practice.
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