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IF 3.6 3区医学 Q2 ONCOLOGY

American journal of cancer research Pub Date : 2025-02-15 eCollection Date: 2025-01-01 DOI:10.62347/FGAY1920

Ping Yang, Shangxiang He, Linyin Fan, Ling Ye, Heng Weng

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引用次数: 0

摘要

目的：免疫疗法的出现改变了晚期非小细胞肺癌（NSCLC）的治疗格局：免疫疗法的出现改变了晚期非小细胞肺癌（NSCLC）的治疗格局；然而，免疫疗法耐药性的出现构成了相当大的障碍。我们的研究试图找出导致免疫疗法耐药的因素，并评估已接受免疫检查点抑制剂（ICIs）治疗的晚期NSCLC患者的后续治疗效果：这项回顾性研究分析了2020年1月至2023年12月期间接受过ICIs治疗的232名晚期NSCLC患者的数据。根据他们对 ICIs 的反应，这些患者被分为两组：免疫耐受组（IM 组）和非免疫耐受组（NIM 组）。收集的数据包括人口统计学、临床参数、细胞因子谱、肿瘤突变负荷（TMB）、PD-L1表达、总生存期（OS）、无进展生存期（PFS）和不良事件。评估了风险因素与免疫耐受之间的关联，并对二线治疗结果进行了评价：免疫耐受的主要风险因素包括较低的TMB、较高水平的白细胞介素-10（IL-10）和PD-L1表达≥50%。TMB与免疫耐受成反比（rho = -0.838，P < 0.001）。在多变量分析中，IL-10仍是一个重要的风险因素（OR = 33.654，P = 0.021），而TMB具有保护作用（OR = 0.786，P < 0.001）。与化疗（OS：7.93±2.13个月；PFS：4.86±1.68个月）相比，二线靶向治疗可明显改善OS（8.72±2.02个月）和PFS（5.37±2.15个月）（P＜0.05）。靶向治疗组出现了明显的副作用，尤其是高血压和手足综合征增加，而化疗组的疲劳发生率更高（P < 0.05）：结论：晚期NSCLC的免疫耐受受IL-10、TMB和PD-L1表达的影响。结论：晚期NSCLC的免疫耐受受IL-10、TMB和PD-L1表达的影响，靶向疗法的疗效优于化疗，但副作用的控制仍然至关重要。

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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Risk factors for immunoresistance in advanced non-small cell lung cancer and the advantages of targeted therapy in improving prognosis.

Objectives: The advent of immunotherapy has transformed the therapeutic landscape for advanced non-small cell lung cancer (NSCLC); nonetheless, the emergence of resistance to immunotherapy poses a considerable obstacle. Our research sought to identify factors contributing to immunotherapy resistance and to assess the effectiveness of subsequent treatments in patients with advanced NSCLC who have been exposed to immune checkpoint inhibitors (ICIs).

Methods: This retrospective study analyzed data from 232 individuals with advanced NSCLC who were treated with ICIs during January 2020 to December 2023. Based on their response to ICIs, these patients were classified into two groups: immunoresistance group (IM group) and non-immunoresistance group (NIM group). Data collected included demographics, clinical parameters, cytokine profiles, tumor mutational burden (TMB), PD-L1 expression, overall survival (OS), progression-free survival (PFS), and adverse events. The association between risk factors and immunoresistance were assessed, and second-line treatment outcomes were evaluated.

Results: Key risk factors for immunoresistance included lower TMB, higher levels of interleukin-10 (IL-10), and PD-L1 expression ≥ 50%. TMB was inversely correlated with immunoresistance (rho = -0.838, P < 0.001). In multivariate analysis, IL-10 remained a significant risk factor (OR = 33.654, P = 0.021), whereas TMB was protective (OR = 0.786, P < 0.001). Second-line targeted therapy significantly improved OS (8.72 ± 2.02 months) and PFS (5.37 ± 2.15 months) compared to chemotherapy (OS: 7.93 ± 2.13 months; PFS: 4.86 ± 1.68 months) (P < 0.05). The targeted therapy group experienced distinct side effects, notably increased hypertension and hand-foot syndrome, while chemotherapy group had higher rates of fatigue (P < 0.05).

Conclusion: Immunoresistance in advanced NSCLC is influenced by IL-10, TMB, and PD-L1 expression. Targeted therapies offer superior outcomes than chemotherapy, though side effect management remains crucial.

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来源期刊

American journal of cancer research ONCOLOGY-

自引率

3.80%

发文量

263

期刊介绍： The American Journal of Cancer Research (AJCR) (ISSN 2156-6976), is an independent open access, online only journal to facilitate rapid dissemination of novel discoveries in basic science and treatment of cancer. It was founded by a group of scientists for cancer research and clinical academic oncologists from around the world, who are devoted to the promotion and advancement of our understanding of the cancer and its treatment. The scope of AJCR is intended to encompass that of multi-disciplinary researchers from any scientific discipline where the primary focus of the research is to increase and integrate knowledge about etiology and molecular mechanisms of carcinogenesis with the ultimate aim of advancing the cure and prevention of this increasingly devastating disease. To achieve these aims AJCR will publish review articles, original articles and new techniques in cancer research and therapy. It will also publish hypothesis, case reports and letter to the editor. Unlike most other open access online journals, AJCR will keep most of the traditional features of paper print that we are all familiar with, such as continuous volume, issue numbers, as well as continuous page numbers to retain our comfortable familiarity towards an academic journal.