CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题：Prognostic value of immune phenotype and PD-L1 status in recurrent or metastatic renal cell carcinoma: an exploratory analysis of the ARCHERY study.
Prognostic value of immune phenotype and PD-L1 status in recurrent or metastatic renal cell carcinoma: an exploratory analysis of the ARCHERY study.
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研究报道了免疫表型或CD8阳性TIL（肿瘤浸润淋巴细胞）的存在与检查点抑制剂抗肿瘤疗效及预后的相关性。多中心回顾性ARCHERY研究（UMIN000034131）收集了2010年至2015年间接受全身治疗的日本复发或转移性肾细胞癌（RCC）患者的组织样本。在这项探索性分析中，利用770份手术标本和ARCHERY入组患者的结局，研究了免疫表型和PD-L1表达（分别及联合）的预后影响。一个关键目标是根据免疫和PD-L1亚组确定总生存期（OS），定义为从肾切除术到任何原因死亡的时间。按免疫表型分组的中位OS在炎症型、排斥型和荒漠型肿瘤患者中分别为28.8、57.3和63.4个月[风险比（95% CI）：炎症型1.78（1.27-2.49）；排斥型1.08（0.89-1.30）；荒漠型为参照]。SP142检测的PD-L1阳性与免疫表型呈强相关；PD-L1阳性患者中分别有88.1%、61.9%和8.7%为炎症型、排斥型和荒漠型表型。PD-L1阳性在每个表型中均与更差的OS相关，但炎症型表型除外（由于PD-L1阴性免疫炎症型亚组样本量有限；n=7）。
此外，PD-L1状态导致的OS差异在荒漠型中大于排斥型[PD-L1阳性 vs 阴性的中位OS：荒漠型27.1 vs 67.2个月，排斥型48.2 vs 78.1个月]。
结果表明，PD-L1表达与免疫表型高度相关，但在判断预后时应同时评估这两个协变量。
Studies have reported the relevance of immune phenotype, or presence of cluster of differentiation 8 (CD8)-positive tumour-infiltrating lymphocytes, to the anti-tumour efficacy of checkpoint inhibitors and to prognosis. The multicentre, retrospective ARCHERY study (UMIN000034131) collected tissue samples from Japanese patients with recurrent or metastatic renal cell carcinoma (RCC) who received systemic therapy between 2010 and 2015. In this exploratory analysis, the prognostic impact of immune phenotype and PD-L1 expression (separately and combined) was investigated using 770 surgical specimens and outcomes from patients enrolled in ARCHERY.
A key objective was to determine overall survival (OS), defined as time from nephrectomy to death from any cause, by immune and PD-L1 subgroups. The median OS by immune phenotype was 28. 8, 57. 3, and 63. 4 months in patients with inflamed, excluded, and desert tumours, respectively [hazard ratio (95% CI): inflamed 1. 78 (1. 27-2. 49); excluded 1. 08 (0. 89-1. 30); desert as reference].
PD-L1 positivity by SP142 showed a strong association with immune phenotype; 88. 1%, 61. 9%, and 8. 7% of PD-L1-positive patients had inflamed, excluded, and desert phenotypes, respectively. PD-L1 positivity was also associated with worse OS in each phenotype, except for the inflamed phenotype (due to limited sample size in the PD-L1-negative immune inflamed subgroup; n=7).
Additionally, the difference in OS by PD-L1 status was larger in the desert versus excluded phenotype [median OS in PD-L1 positive vs negative: 27. 1 vs 67. 2 months (desert), and 48. 2 vs 78. 1 months (excluded)]. Results show that PD-L1 expression was highly associated with immune phenotype, but both covariates should be evaluated when determining prognosis.
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