{"title":"Exploring prognostic factors for survival in patients with advanced pancreatic cancer undergoing PD-1 inhibitor immunotherapy.","authors":"Yue Ma, Shiyun Chen, Guanghai Dai","doi":"10.1080/21645515.2024.2376429","DOIUrl":null,"url":null,"abstract":"<p><p>Immunotherapy, led by programmed cell death protein-1 (PD-1) inhibitors, has emerged as a prominent antitumor therapy, yet prognostic challenges persist in pancreatic cancer (PC). This retrospective, single-center study evaluated prognostic factors in advanced PC patients treated with PD-1 inhibitors at the PLA General Hospital's Oncology Department from 2015-2022. With ethics approval by the Ethics Committee of the General Hospital of the People's Liberation Army (S2021-228-03), we analyzed 126 patients using Kaplan-Meier and Cox models. <i>p</i> < .05 was considered a statistically significant difference. Median overall survival (mOS) and progression-free survival (mPFS) were 12.1 and 4.6 months, respectively. Significant mOS predictors were surgery history (44.2 months vs. 10 months, *<i>p</i> = .022), absence of liver metastases (44.2 months vs. 6.4 months, *<i>p</i> = .034), and baseline CA19-9 ≤ 216.15 U/ml (18.5 months vs. 9.2 months, *<i>p</i> = .049). For mPFS, histologic differentiation (5.5 months vs. 3.2 months, *<i>p</i> = .022) and first-line PD-1 inhibitor use (5.1 months vs. 1.5 months, ***<i>p</i> = .001) were key. Subgroup analyses highlighted early progression in low histologic differentiation and earlier death without surgery. History of surgery, absence of liver metastases, baseline CA19-9 level, and histologic intermediate/high differentiation may predict PD-1 inhibitor efficacy in advanced PC, pending validation in prospective trials.</p>","PeriodicalId":49067,"journal":{"name":"Human Vaccines & Immunotherapeutics","volume":"20 1","pages":"2376429"},"PeriodicalIF":4.1000,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11268236/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Human Vaccines & Immunotherapeutics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/21645515.2024.2376429","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/23 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"BIOTECHNOLOGY & APPLIED MICROBIOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Immunotherapy, led by programmed cell death protein-1 (PD-1) inhibitors, has emerged as a prominent antitumor therapy, yet prognostic challenges persist in pancreatic cancer (PC). This retrospective, single-center study evaluated prognostic factors in advanced PC patients treated with PD-1 inhibitors at the PLA General Hospital's Oncology Department from 2015-2022. With ethics approval by the Ethics Committee of the General Hospital of the People's Liberation Army (S2021-228-03), we analyzed 126 patients using Kaplan-Meier and Cox models. p < .05 was considered a statistically significant difference. Median overall survival (mOS) and progression-free survival (mPFS) were 12.1 and 4.6 months, respectively. Significant mOS predictors were surgery history (44.2 months vs. 10 months, *p = .022), absence of liver metastases (44.2 months vs. 6.4 months, *p = .034), and baseline CA19-9 ≤ 216.15 U/ml (18.5 months vs. 9.2 months, *p = .049). For mPFS, histologic differentiation (5.5 months vs. 3.2 months, *p = .022) and first-line PD-1 inhibitor use (5.1 months vs. 1.5 months, ***p = .001) were key. Subgroup analyses highlighted early progression in low histologic differentiation and earlier death without surgery. History of surgery, absence of liver metastases, baseline CA19-9 level, and histologic intermediate/high differentiation may predict PD-1 inhibitor efficacy in advanced PC, pending validation in prospective trials.
以程序性细胞死亡蛋白-1(PD-1)抑制剂为首的免疫疗法已成为一种重要的抗肿瘤疗法,但胰腺癌(PC)的预后仍面临挑战。这项回顾性单中心研究评估了2015-2022年期间在解放军总医院肿瘤科接受PD-1抑制剂治疗的晚期PC患者的预后因素。经中国人民解放军总医院伦理委员会伦理批准(S2021-228-03),我们使用Kaplan-Meier和Cox模型对126名患者进行了分析。 在预后因素方面,PD-1抑制剂可用于治疗晚期PC患者,而PD-1抑制剂则可用于治疗晚期PC患者。PD-1抑制剂可用于治疗晚期PC患者的预后因素包括:肝转移(44.2个月 vs. 6.4个月,*P = .022)、无肝转移(44.2个月 vs. 6.4个月,*P = .034)和基线CA19-9≤216.15 U/ml(18.5个月 vs. 9.2个月,*P = .049)。对于mPFS,组织学分化(5.5个月 vs. 3.2个月,*p = .022)和一线使用PD-1抑制剂(5.1个月 vs. 1.5个月,***p = .001)是关键因素。亚组分析显示,组织学分化程度低的患者病情进展较早,未接受手术的患者死亡较早。手术史、无肝转移、基线CA19-9水平和组织学中/高分化可预测PD-1抑制剂在晚期PC中的疗效,但有待前瞻性试验验证。
期刊介绍:
(formerly Human Vaccines; issn 1554-8619)
Vaccine research and development is extending its reach beyond the prevention of bacterial or viral diseases. There are experimental vaccines for immunotherapeutic purposes and for applications outside of infectious diseases, in diverse fields such as cancer, autoimmunity, allergy, Alzheimer’s and addiction. Many of these vaccines and immunotherapeutics should become available in the next two decades, with consequent benefit for human health. Continued advancement in this field will benefit from a forum that can (A) help to promote interest by keeping investigators updated, and (B) enable an exchange of ideas regarding the latest progress in the many topics pertaining to vaccines and immunotherapeutics.
Human Vaccines & Immunotherapeutics provides such a forum. It is published monthly in a format that is accessible to a wide international audience in the academic, industrial and public sectors.