关键词: Hot tumor microenvironment Immune checkpoint inhibitors (ICIs) Malignancy Viral infection efficacy

Mesh : Humans Immune Checkpoint Inhibitors / therapeutic use Carcinoma, Hepatocellular Hepatitis C / drug therapy Hepacivirus Papillomavirus Infections / complications Liver Neoplasms Head and Neck Neoplasms Nasopharyngeal Neoplasms

来  源:   DOI:10.1007/s00262-024-03663-z   PDF(Pubmed)

Abstract:
BACKGROUND: Pre-clinical data have revealed that viral infection, such as Hepatitis B virus (HBV), Hepatitis C virus (HCV), and Human Papilloma virus (HPV), may lead to the development of \"hot\" or \"immune-sensitive\" tumors, which may impact the efficacy of immune checkpoint inhibitor (ICIs). Therefore, This study aimed to investigate the impact of viral status on the efficacy of ICIs.
METHODS: Electronic databases were searched to identify relevant trials. The primary endpoints were overall survival (OS) and progression-free survival (PFS) measured by hazard ratio (HR). Stratified analyses were accomplished based on viral types, treatment regimens, and patient locations.
RESULTS: A total of 3255 participants were recruited, including 252 cases of gastric cancer, 156 cases of nasopharyngeal carcinoma, 1603 cases of hepatocellular carcinoma, and 1244 cases of head and neck squamous cell carcinoma. Pooled results demonstrated a significant association between viral infection and favorable outcomes in patients receiving ICIs, including improved OS [HR = 0.67, 95%CI (0.57-0.79), P < 0.0001], increased ORR [OR = 1.43, 95%CI (1.14-1.80), P = 0.0018], and a trend toward enhanced PFS [HR = 0.75, 95%CI (0.56-1.00), P = 0.05]. In subgroup analyses, patients treated with ICIs who were exposed to HBV/HCV or HPV infection exhibited an evidently superior OS without heterogeneity, compared to those without infection.
CONCLUSIONS: This study indicated that the presence of viral infection was evidently associated with improved outcomes in cancer patients undergoing ICIs, particularly in cases of HBV/HCV and HPV infections.
摘要:
背景:临床前数据显示,病毒感染,如乙型肝炎病毒(HBV),丙型肝炎病毒(HCV),和人乳头瘤病毒(HPV),可能导致“热”或“免疫敏感”肿瘤的发展,这可能会影响免疫检查点抑制剂(ICIs)的疗效。因此,本研究旨在探讨病毒状态对ICI疗效的影响。
方法:检索电子数据库以确定相关试验。主要终点是通过风险比(HR)测量的总生存期(OS)和无进展生存期(PFS)。根据病毒类型完成分层分析,治疗方案,和病人的位置。
结果:共招募了3255名参与者,包括252例胃癌,鼻咽癌156例,1603例肝细胞癌,头颈部鳞状细胞癌1244例。汇总结果表明,病毒感染与接受ICIs的患者的良好预后之间存在显着关联。包括改进的OS[HR=0.67,95CI(0.57-0.79),P<0.0001],增加的ORR[OR=1.43,95CI(1.14-1.80),P=0.0018],以及提高PFS的趋势[HR=0.75,95CI(0.56-1.00),P=0.05。在亚组分析中,与ICIs谁暴露于HBV/HCV或HPV感染治疗患者表现出明显优越的OS无异质性,与没有感染的人相比。
结论:这项研究表明,在接受ICI治疗的癌症患者中,病毒感染的存在与改善预后明显相关。特别是在HBV/HCV和HPV感染的情况下。
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