背景:贝伐单抗,抗血管内皮生长因子(VEGF)单克隆抗体,抑制血管生成和减少肿瘤生长。血清VEGF-C,乳酸脱氢酶,和炎症标志物已被报道为与贝伐单抗治疗相关的预测标志物。程序性细胞死亡配体1(PD-L1)可作用于VEGF受体2,诱导癌细胞血管生成和转移。
目的:根据PD-L1的表达观察转移性结直肠癌患者应用贝伐单抗化疗的疗效。
方法:该分析包括2014年6月24日至2022年2月28日在三星医疗中心接受贝伐单抗联合FOLFOX或FOLFIRI作为一线治疗的CRC患者(首尔,韩国)。对患者数据的分析包括通过组合阳性评分(CPS)评估PD-L1表达。我们根据CRC患者的PD-L1表达状态分析了贝伐单抗的疗效。
结果:本分析共纳入124例患者。几乎所有患者均接受贝伐单抗联合FOLFIRI或FOLFOX作为一线化疗。虽然77%的患者接受了FOLFOX,23%接受FOLFIRI作为骨干一线化疗。PD-L1CPS为1或以上的患者人数,5或更多,或10或更多为105(85%),64(52%),32(26%),分别。结果显示,PD-L1CPS小于1的患者与PD-L1CPS大于或等于1的患者(PD-L1<1%vsPD-L1≥1%;PFS:P=0.93,OS:P=0.33),使用贝伐单抗治疗的无进展生存期(OS)没有显着差异。在PD-L1CPS小于5且大于或等于5的患者之间(PD-L1<5%vsPD-L1≥5%;PFS:P=0.409,OS:P=0.746),PD-L1CPS小于10且大于或等于10的患者之间(PD-L1<10%vsPD-L1≥10%;PFS:P=0.529,OS:P=0.568)。
结论:含贝伐单抗的化疗可被视为转移性CRC的一线治疗,而与PD-L1表达无关。
BACKGROUND: Bevacizumab, an anti-vascular endothelial growth factor (VEGF) monoclonal antibody, inhibits angiogenesis and reduces tumor growth. Serum VEGF-C, lactate dehydrogenase, and inflammatory markers have been reported as predictive markers related to bevacizumab treatment. Programmed cell death ligand 1 (PD-L1) could act upon VEGF receptor 2 to induce cancer cell angiogenesis and metastasis.
OBJECTIVE: To investigate the efficacy of bevacizumab-containing chemotherapy in patients with metastatic colorectal cancer (CRC) according to the expression of PD-L1.
METHODS: This analysis included CRC patients who received bevacizumab plus FOLFOX or FOLFIRI as first-line therapy between June 24, 2014 and February 28, 2022, at Samsung Medical Center (Seoul, South Korea). Analysis of patient data included evaluation of PD-L1 expression by the combined positive score (CPS). We analyzed the efficacy of bevacizumab according to PD-L1 expression status in patients with CRC.
RESULTS: A total of 124 patients was included in this analysis. Almost all patients were treated with bevacizumab plus FOLFIRI or FOLFOX as the first-line chemotherapy. While 77% of patients received FOLFOX, 23% received FOLFIRI as backbone first-line chemotherapy. The numbers of patients with a PD-L1 CPS of 1 or more, 5 or more, or 10 or more were 105 (85%), 64 (52%), and 32 (26%), respectively. The results showed no significant difference in progression-free survival (PFS) and overall survival (OS) with bevacizumab treatment between patients with PD-L1 CPS less than 1 and those with PD-L1 CPS of 1 or more (PD-L1 < 1% vs PD-L1 ≥ 1%; PFS: P = 0.93, OS: P = 0.33), between patients with PD-L1 CPS less than 5 and of 5 or more (PD-L1 < 5% vs PD-L1 ≥ 5%; PFS: P = 0.409, OS: P = 0.746), and between patients with PD-L1 CPS less than 10 and of 10 or more (PD-L1 < 10% vs PD-L1 ≥ 10%; PFS: P = 0.529, OS: P = 0.568).
CONCLUSIONS: Chemotherapy containing bevacizumab can be considered as first-line therapy in metastatic CRC irrespective of PD-L1 expression.