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HER2 阳性晚期胃癌患者一线氟尿嘧啶-铂类双药联合曲妥珠单抗治疗中 NK 细胞活性的预后价值

英文原题:Prognostic value of natural killer cell activity for patients with HER2 + advanced gastric cancer treated with first-line fluoropyrimidine-platinum doublet plus trastuzumab.

PubMed 2021/08/22(内容时间) Cancer Immunol Immunother Q1 · IF 5.8(JCR 2025)

研究概要

我们的结果证明了基线 NK 细胞活性对接受氟尿嘧啶-铂类双药联合曲妥珠单抗治疗的 HER2 + AGC 患者的预后价值。

中文摘要

背景:本研究旨在评估一线氟嘧啶-铂类双药联合曲妥珠单抗治疗HER2阳性晚期胃癌(AGC)患者中,自然杀伤(NK)细胞活性的预后价值。方法:前瞻性纳入41例接受氟嘧啶-铂类双药联合曲妥珠单抗一线治疗的HER2阳性AGC患者,采用NK Vue检测NK细胞活性。结果:患者年龄中位数为63.5岁,男性31例(75.6%)。与基线NK细胞活性高于中位数的患者(n=20)相比,活性低于或等于中位数的患者(n=21)无进展生存期(PFS)和总生存期(OS)较差:中位PFS分别为4.21个月和9.53个月(P<0.001),中位OS分别为8.15个月和17.82个月(P=0.025)。多变量分析显示,基线NK细胞活性低与PFS较差独立相关(风险比[HR] 4.35,P=0.007)。在基线活性偏低的19例患者中,9例(47.4%)治疗2个周期后NK细胞活性恢复至正常范围。NK细胞活性恢复者的中位PFS和OS显著优于活性持续偏低者(PFS:P=0.038;OS:P=0.003)。结论:结果显示,基线NK细胞活性对接受氟嘧啶-铂类双药联合曲妥珠单抗治疗的HER2阳性AGC患者具有预后价值。治疗结局与NK细胞活性动态变化之间的关联提示,NK细胞治疗可能改善疗效,尤其对基线NK细胞活性低的患者。

展开英文摘要原文

BACKGROUND: We aimed to evaluate the prognostic value of natural killer (NK) cell activity for patients with HER2 + advanced gastric cancer (AGC) treated with first-line fluoropyrimidine-platinum doublet plus trastuzumab. METHODS: Forty-one patients with HER2 + AGC who received fluoropyrimidine-platinum doublet plus trastuzumab as first-line treatment were prospectively enrolled. NK cell activity was evaluated using the NK Vue . RESULTS: The median age was 63.5 years, and 31 patients (75.6%) were male. Patients with low baseline NK cell activity ( median, n = 21) were associated worse progression-free survival (PFS) and overall survival (OS) compared with patients with high baseline NK cell activity (> median, n = 20) with a median PFS of 4.21 vs. 9.53 months (P < 0.001), and median OS of 8.15 months vs. 17.82 months (P = 0.025), respectively. In the multivariate analysis, low baseline NK cell activity was independently associated with poor PFS (HR 4.35, P = 0.007). NK cell activity recovered to a normal range in nine patients (47.4%) with a low baseline NK cell activity (n = 19) after two cycles of treatment. The median PFS and OS among patients with recovered NK cell activity were significantly better than that among patients with persistently low NK cell activity (PFS, P = 0.038; OS, P = 0.003). CONCLUSION: Our results demonstrated the prognostic value of baseline NK cell activity for patients with HER2 + AGC treated with fluoropyrimidine-platinum doublet plus trastuzumab. The association between treatment outcomes and dynamic changes in NK cell activity suggests that NK cell treatment may improve treatment outcomes, especially for patients with low baseline NK cell activity.

论文信息

作者
Cho H、Ryu MH、Lee HE、Kim HD、Kang YK
第一作者单位
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.South Korea
通讯作者单位
Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea. ykkang@amc.seoul.kr.South Korea
期刊
Cancer immunology, immunotherapy : CII2022 Apr
原文标识
PubMed 34420059 · DOI 10.1007/s00262-021-03035-x