帕博利珠单抗联合二甲双胍治疗转移性头颈部癌的 II 期可行性研究
A Phase II Feasibility Study Combining Pembrolizumab and Metformin in Patients with Metastatic Head and Neck Cancer.
二甲双胍联合帕博利珠单抗耐受性良好,仅出现轻度胃肠道不良事件,并展现出有前景的活性,值得在随机试验中进一步研究。
英文原题:CD161 serves as a prognostic biomarker and predicts immunotherapy response in head and neck squamous cell carcinoma.
CD161在HNSCC中表达下调。CD161高表达与良好预后和免疫炎症型肿瘤微环境相关,并可能预测对含ICI治疗的反应。这些发现表明,CD161具有作为预后生物标志物的潜力,并可能有助于描述HNSCC中的肿瘤-免疫相互作用。
尽管免疫检查点抑制剂(ICIs)取得了进展,头颈部鳞状细胞癌(HNSCC)患者的预后仍然较差,且仍缺乏可靠的生物标志物来预测临床结局。CD161是一种表达于多种T细胞亚群上的凝集素样受体,已被报道可抑制T细胞细胞毒性;然而,其在HNSCC中的预后和免疫学意义仍不清楚。
我们分析了TCGA数据库中HNSCC队列以及四个GEO数据集(GSE6631、GSE102349、GSE159067和GSE103322)的转录组数据,以评估CD161的表达、其预后意义及其与免疫浸润和功能通路的关联。单细胞RNA测序数据用于识别表达CD161的细胞亚群。差异表达通过20对HNSCC及癌旁正常组织的免疫组织化学(IHC)进一步验证。CD161表达与免疫治疗反应之间的关联还在一个由33名接受ICI治疗的患者组成的独立队列中进行了额外评估。
在TCGA队列和GSE6631数据集中,CD161在HNSCC组织中的表达显著低于正常组织,IHC分析进一步证实了这一点。CD161高表达与良好预后相关,表现为更长的总生存期(OS)和疾病特异性生存期(DSS),并在多因素分析中仍为独立保护因素(OS:风险比[HR] = 0.92,95%置信区间[CI]:0.86-0.99,p = 0.019;DSS:HR = 0.86,95% CI:0.78-0.96,p = 0.008)。CD161表达与CD8 + T细胞和调节性T细胞的浸润相关,也与多种免疫检查点分子相关,包括CD27、TIGIT、BTLA和PD-1。单细胞分析进一步将CD161主要定位在CD4 + T细胞。在GSE159067数据集中,CD161高表达与更长的无进展生存期和总生存期相关。在我们的ICI治疗队列中,CD161高表达与更长的PFS和更高的客观缓解率相关。
BACKGROUND: Despite advances in immune checkpoint inhibitors (ICIs), the prognosis of patients with head and neck squamous cell carcinoma (HNSCC) remains poor, and reliable biomarkers for predicting clinical outcomes are still lacking. CD161, a lectin-like receptor expressed on multiple T-cell subsets, has been reported to inhibit T-cell cytotoxicity; however, its prognostic and immunological significance in HNSCC remains unclear. METHODS: We analyzed transcriptomic data from the HNSCC cohort in the TCGA database and four GEO datasets (GSE6631, GSE102349, GSE159067, and GSE103322) to evaluate CD161 expression, its prognostic significance, and its association with immune infiltration and functional pathways. Single-cell RNA sequencing data were used to identify CD161-expressing cell subsets. Differential expression was further validated by immunohistochemistry (IHC) in 20 paired HNSCC and adjacent normal tissues. The association between CD161 expression and immunotherapy response was additionally assessed in an independent cohort of 33 ICI-treated patients. RESULTS: CD161 expression was significantly lower in HNSCC tissues than in normal tissues in the TCGA cohort and the GSE6631 dataset, which was further confirmed by IHC analysis. High CD161 expression was associated with a favorable prognosis, with longer overall survival (OS) and disease-specific survival (DSS), and remained an independent protective factor in multivariate analysis (OS: hazard ratio [HR] = 0.92, 95% confidence interval [CI]: 0.86-0.99, p = 0.019; DSS: HR = 0.86, 95% CI: 0.78-0.96, p = 0.008). CD161 expression correlated with infiltration of CD8 + T cells and regulatory T cells, as well as with multiple immune checkpoint molecules, including CD27, TIGIT, BTLA, and PD-1. Single-cell analysis further localized CD161 predominantly to CD4 + T cells. In the GSE159067 dataset, high CD161 expression was associated with longer progression-free survival and overall survival. In our ICI-treated cohort, high CD161 expression correlated with longer PFS and higher objective response rate. CONCLUSION: CD161 is downregulated in HNSCC. Higher CD161 expression is associated with favorable prognosis and an immune-inflamed tumor microenvironment, and may predict response to ICI-containing therapy. These findings suggest that CD161 has potential as a prognostic biomarker and may help characterize tumor-immune interactions in HNSCC.
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