背景:肿瘤免疫疗法最近已成为肿瘤学治疗研究的关键焦点。在肿瘤免疫治疗方法中,肿瘤免疫检查点抑制剂(ICIs)在临床研究中引起了广泛关注。然而,这种治疗方式仅使少数患者受益。我们对各种生物标志物进行了荟萃分析,以破译其在接受ICIs治疗的头颈部鳞状细胞癌(HNSCC)患者中的预后意义。从而鉴定出具有实际临床相关性的预测性标志物。
方法:对电子数据库进行系统检索,以确定检查HNSCC患者生物标志物与治疗结果之间相关性的临床研究。对纳入的文章进行筛选和分析,以提取有关总生存期(OS)和无进展生存期(PFS)的数据。
结果:摘要中包含的生物标志物与预后之间的关系如下:HPV阳性与OS改善相关(HR=0.76,95%CI=0.58-1.99),PFS(HR=1.16,95%CI=0.81-1.67),和反应(OR=1.67,95%CI=1.37-2.99)。PD-L1阳性与OS相关(HR=0.71,95%CI=0.59-0.85),PFS(HR=0.5695%CI=0.43-0.73),和反应(OR=2.16,95%CI=1.51-3.10)。HPV阳性和PD-L1阳性均与DCR无关。为OS和PFS数据收集以下标记,并与较长的OS相关:较低的格拉斯哥预后评分(GPS/mGPS)分级,较低的PS分级,高体重指数(BMI),低中性粒细胞与淋巴细胞比率(NLR),低血小板淋巴细胞比(PLR),高白蛋白(Alb),低乳酸脱氢酶(LDH)。与更好的PFS相关的因素是较低的GPS/mGPS分级,较低的PS分级,高BMI,低NLR,高绝对淋巴细胞计数,低LDH。高进行性疾病与OS和PFS恶化相关。关于肿瘤微环境和缺氧的临床研究较少,微卫星不稳定性/DNA错配修复,和微生物组和系统分析是困难的。
结论:在我们的荟萃分析中,不同的免疫检查点因子与接受免疫治疗的HNSCC患者的不同预后相关.HPV,PD-L1,BMI,Alb,火警局,PS,GPS/mGPS,LDH,NLR,PLR可预测HNSCC患者的ICI结局。
BACKGROUND: Tumor immunotherapy has recently emerged as a crucial focal point in oncology treatment research. Among tumor immunotherapy approaches, tumor immune checkpoint inhibitors (ICIs) have attracted substantial attention in clinical research. However, this treatment modality has benefitted only a limited number of patients. We conducted a meta-analysis of various biomarkers to decipher their prognostic implications in patients with head and neck squamous cell carcinoma (HNSCC) who are treated with ICIs, and thus identify predictive markers with practical clinical relevance.
METHODS: A systematic search of electronic databases was conducted to identify clinical studies that examined the correlation between biomarkers and treatment outcomes in the HNSCC patients. The included articles were screened and analyzed to extract data regarding overall survival (OS) and progression-free survival (PFS).
RESULTS: The relationship between the biomarkers included in the summary and prognosis was as follows: HPV positivity was associated with improved OS (HR = 0.76, 95% CI = 0.58-1.99), PFS (HR = 1.16, 95% CI = 0.81-1.67), and response (OR = 1.67, 95% CI = 1.37-2.99). PD-L1 positivity was associated with OS (HR = 0.71, 95% CI = 0.59-0.85), PFS (HR = 0.56 95% CI = 0.43-0.73), and response (OR = 2.16, 95% CI = 1.51-3.10). Neither HPV positivity nor PD-L1 positivity was associated with DCR. The following markers were collected for OS and PFS data and were associated with longer OS: lower Glasgow prognostic score (GPS/mGPS) grading, lower PS grading, high body mass index (BMI), low neutrophil-to-lymphocyte ratio (NLR), low platelet-to-lymphocyte ratio (PLR), high albumin (Alb), low lactate dehydrogenase (LDH). Factors associated with better PFS were lower GPS/mGPS grading, lower PS grading, high BMI, low NLR, high absolute lymphocyte count, and low LDH. Hyperprogressive disease was associated with worse OS and PFS. Fewer clinical studies have been completed on the tumor microenvironment and hypoxia, microsatellite instability/DNA mismatch repair, and microbiome and systematic analysis is difficult.
CONCLUSIONS: In our meta-analysis, different immune checkpoint factors were associated with different prognoses in HNSCC patients receiving immunotherapy. HPV, PD-L1, BMI, Alb, HPD, PS, GPS/mGPS, LDH, NLR, and PLR predicted the ICI outcome in HNSCC patients.