PD-1/PD-L1 Inhibitor Plus Chemotherapy Versus PD-1/PD-L1 Inhibitor in Microsatellite Instability Gastrointestinal Cancers: A Multicenter Retrospective Study

被引：1

作者：

Chen, Mifen ^{[1
]}

Wang, Zhenghang ^{[1
]}

Liu, Zimin ^{[2
]}

Deng, Ting ^{[3
]}

Wang, Xiaodong ^{[4
]}

Chang, Zhiwei ^{[5
]}

Zhang, Qi ^{[1
]}

Yang, Wenlei ^{[6
]}

Liu, Ning ^{[2
]}

Ji, Zhi ^{[3
]}

Zhang, Xiaotian ^{[1
]}

Wang, Xicheng ^{[1
]}

Peng, Zhi ^{[1
]}

Li, Yi ^{[5
]}

Cao, Yujuan ^{[4
]}

Jin, Xuan ^{[7
]}

Lu, Hongxia ^{[8
]}

Qu, Huajun ^{[9
]}

Tang, Yong ^{[10
]}

Xu, Chunlei ^{[10
]}

Fang, Weijia ^{[11
]}

Zhang, Hangyu ^{[11
]}

Yan, Dong ^{[12
]}

Wang, Li ^{[12
]}

Li, Jiayi ^{[13
,14
]}

Zhang, Jingdong ^{[15
]}

Wang, Qiwei ^{[15
]}

Xue, Liying ^{[16
]}

Yin, Fei ^{[17
]}

Han, Guangjie ^{[17
]}

Cheng, Zhiqiang ^{[18
]}

Liu, Qing ^{[18
]}

Jin, Yongdong ^{[19
]}

Zhang, Yinjie ^{[19
]}

Li, Lanxing ^{[19
]}

Cao, Baoshan ^{[20
]}

Yao, Yanhong ^{[20
]}

Chen, Zhiyu ^{[21
]}

Zou, Jianling ^{[21
]}

Ying, Jieer ^{[22
]}

Wei, Qing ^{[22
]}

Tian, Tiantian ^{[23
,24
]}

Zhao, Weifeng ^{[25
]}

Li, Longmei ^{[26
]}

Zhang, Tong ^{[27
]}

Song, Fanghua ^{[28
]}

Ba, Ya-er ^{[29
]}

Li, Na ^{[30
]}

Gao, Hui ^{[31
]}

Ji, Yinghua ^{[32
]}

机构：

[1] Peking Univ Canc Hosp & Inst, Dept Gastrointestinal Oncol, Key Lab Carcinogenesis & Translat Res, Minist Educ, Beijing, Peoples R China

[2] Qingdao Univ, Affiliated Hosp, Dept Oncol, Qingdao, Shandong, Peoples R China

[3] Tianjin Med Univ, Natl Clin Res Ctr Canc, Tianjins Clin Res Ctr Canc,Canc Inst & Hosp, Dept Gastrointestinal Oncol,Key Lab Canc Prevent, Tianjin, Peoples R China

[4] Peking Univ, Shougang Hosp, Dept Oncol, Beijing, Peoples R China

[5] Zhengzhou Univ, Affiliated Hosp 1, Dept Oncol, Zhengzhou, Henan, Peoples R China

[6] Peking Univ Canc Hosp & Inst, Key Lab Carcinogenesis & Translat Res, Minist Educ Beijing, Lab Genet, Beijing, Peoples R China

[7] Peking Univ First Hosp, Dept Med Oncol, Beijing, Peoples R China

[8] Chinese Acad Med Sci, Shanxi Med Univ, Shanxi Prov Canc Hosp, Shanxi Hosp,Canc Hosp,Dept Gastroenterol, Taiyuan, Shanxi, Peoples R China

[9] Qingdao Univ, Affiliated Yantai Yuhuangding Hosp, Dept Med Oncol, Yantai, Shandong, Peoples R China

[10] Xinjiang Med Univ, Affiliated Tumor Hosp, Dept Digest Internal Med, Urumqi, Xinjiang, Peoples R China

[11] Zhejiang Univ, Affiliated Hosp 1, Sch Med, Dept Med Oncol, Hangzhou, Zhejiang, Peoples R China

[12] Capital Med Univ, Beijing Luhe Hosp, Dept Oncol, Beijing, Peoples R China

[13] Xiamen Univ, Affiliated Hosp 1, Dept Med Oncol, Xiamen, Peoples R China

[14] Xiamen Univ, Sch Med, Xiamen, Peoples R China

[15] China Med Univ, Canc Hosp, Liaoning Canc Hosp & Inst, Med Oncol Dept Gastrointestinal Canc, Shenyang, Peoples R China

[16] Peoples Hosp Inner Mongolia Autonomous Reg, Dept Med Oncol, Hohhot, Inner Mongolia, Peoples R China

[17] Hebei Med Univ, Hosp 4, Dept Gastroenterol & Hepatol, Shijiazhuang, Hebei, Peoples R China

[18] China Japan Friendship Hosp, Dept Integrat Oncol, Beijing, Peoples R China

[19] Univ Elect Sci & Technol China, Sichuan Canc Hosp & Inst, Sch Med, Sichuan Canc Ctr,Dept Med Oncol, Chengdu, Sichuan, Peoples R China

[20] Peking Univ Third Hosp, Dept Med Oncol & Radiat Sickness, Beijing, Peoples R China

[21] Fudan Univ, Shanghai Canc Ctr, Dept Gastrointestinal Med Oncol, Shanghai, Peoples R China

[22] Chinese Acad Sci, Univ Chinese Acad Sci, Zhejiang Canc Hosp, Canc Hosp,Inst Basic Med & Canc IBMC,Dept Abdomin, Hangzhou, Zhejiang, Peoples R China

[23] Shandong First Med Univ, Affiliated Hosp 1, Dept Oncol, Jinan, Shandong, Peoples R China

[24] Shandong Prov Qianfoshan Hosp, Jinan, Shandong, Peoples R China

[25] Henan Univ, Zhengzhou Univ, Henan Prov Peoples Hosp, Peoples Hosp,Dept Oncol, Zhengzhou, Henan, Peoples R China

[26] Guangzhou Univ Chinese Med, Guangdong Prov Hosp Chinese Med, Clin Coll 2, Dept Oncol, Guangzhou, Guangdong, Peoples R China

[27] China Acad Chinese Med Sci, Xiyuan Hosp, Dept Oncol, Beijing, Peoples R China

[28] Dalian Univ, Affiliated Xinhua Hosp, Dept Oncol, Dalian, Liaoning, Peoples R China

[29] Baotou Canc Hosp, Dept Internal Med, Baotou, Inner Mongolia, Peoples R China

[30] Suining Cent Hosp, Canc Ctr, Suining, Sichuan, Peoples R China

[31] Zhengzhou Univ, Zhengzhou Cent Hosp, Dept Oncol Rehabil, Zhengzhou, Henan, Peoples R China

[32] Xinxiang Med Univ, Affiliated Hosp 1, Dept Oncol, Xinxiang, Henan, Peoples R China

[33] Manzhouli Peoples Hosp, Dept Med Oncol, Manzhouli, Inner Mongolia, Peoples R China

[34] 3D Med Inc, Med Affairs, Shanghai, Peoples R China

来源：

JCO PRECISION ONCOLOGY | 2023年 / 7卷

基金：

中国国家自然科学基金;

关键词：

REPAIR-DEFICIENT; SOLID TUMORS; OPEN-LABEL; NIVOLUMAB; PEMBROLIZUMAB; BURDEN; CHINA;

D O I：

10.1200/PO.22.00463

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

PURPOSETo investigate the efficacy of PD-1/PD-L1 inhibitors plus chemotherapy versus anti-PD-1/PD-L1 monotherapy in advanced microsatellite instability (MSI)/mismatch repair-deficient (dMMR) gastrointestinal cancers.METHODSWe retrospectively recruited patients with MSI/dMMR gastrointestinal cancer who received anti-PD-1/PD-L1 with or without chemotherapy and compared objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS) of PD-1/PD-L1 inhibitor plus chemotherapy (chemo-anti-PD-1/PD-L1 group) and PD-1/PD-L1 inhibitor alone (anti-PD-1/PD-L1 group). Propensity score-based overlap weighting analysis was conducted to adjust the baseline covariable imbalance. Sensitivity analysis was performed to confirm the stability of the results by propensity score matching and multivariable Cox and logistic regression models.RESULTSA total of 256 patients were eligible, with 68 and 188 receiving chemo-anti-PD-1/PD-L1 and anti-PD-1/PD-L1, respectively. The chemo-anti-PD-1/PD-L1 group showed significant improvements versus the anti-PD-1/PD-L1 group in ORR (61.8% v 38.8%; P = .001), DCR (92.6% v 74.5%; P = .002), PFS (median PFS [mPFS], not reached [NR] v 27.9 months; P = .004), and OS (median OS [mOS], NR v NR; P = .014). After overlap weighting, the improvements tended to be more significant with chemo-anti-PD-1/PD-L1 versus anti-PD-1/PD-L1 in ORR (62.5% v. 38.3%; P < .001), DCR (93.8% v 74.2%; P < .001), PFS (mPFS, NR v 26.0 months; P = .004), and OS (mOS, NR v NR; P = .010). These results were solidified through sensitivity analysis.CONCLUSIONChemo-anti-PD-1/PD-L1 is superior to anti-PD-1/PD-L1 in MSI/dMMR gastrointestinal cancers with improved efficacy.

引用

页数：20

共 50 条

[31] Dostarlimab an Inhibitor of PD-1/PD-L1: A New Paradigm for the Treatment of Cancer
Alkholifi, Faisal K.
Alsaffar, Rana M.
MEDICINA-LITHUANIA, 2022, 58 (11):
[32] The rational design and evaluation of a peptide inhibitor of the PD-1/PD-L1 interaction
Boohaker, Rebecca J.
Sambandam, Vijaya
Suto, Mark
Xu, Bo
CANCER RESEARCH, 2018, 78 (13)
[33] Budget and Health Impact of the PD-1/PD-L1 inhibitor class in Austria
van Bavel, J.
Lucherini, S.
Zeilinski, C.
Walters, E.
Eckart, G.
Davies, N.
Okhuoya, P.
Pellisier, J.
Roediger, A.
EUROPEAN JOURNAL OF PUBLIC HEALTH, 2018, 28 : 438 - 438
[34] Relevance of host and tumor PD-L1 expression in PD-L1 and PD-1 blockade
Lin, Heng
Wei, Shuang
Vatan, Linda
Kryczek, Ilona
Zou, Weiping
JOURNAL OF IMMUNOLOGY, 2017, 198 (01):
[35] Measurement of soluble PD-1 and soluble PD-L1 as well as PD-L1 and PD-1 from perioperative patients with gastric carcinoma
Wei, Hangzhi
Wu, Fahong
Mao, Yudong
Zhang, Youcheng
Leng, Guangxian
Wang, Jia
Zhang, Wei
Wang, Tianwei
JAPANESE JOURNAL OF CLINICAL ONCOLOGY, 2022, 52 (04) : 331 - 345
[36] Value assessment of PD-1/ PD-L1 inhibitors in the treatment of oesophageal and gastrointestinal cancers
Ou, Shun-Long
Luo, Jing
Wei, Hua
Qin, Xiao-Li
Jiang, Qian
FRONTIERS IN PHARMACOLOGY, 2023, 14
[37] The roles of PD-1/PD-L1 and its signalling pathway in gastrointestinal tract cancers
Cui, Chunguo
Yu, Bo
Jiang, Qi
Li, Xingfang
Shi, Kaiyao
Yang, Zecheng
CLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, 2019, 46 (01) : 3 - 10
[38] Clinical Development of PD-1/ PD-L1 Immunotherapy for Gastrointestinal Cancers: Facts and Hopes
Chau, Ian
CLINICAL CANCER RESEARCH, 2017, 23 (20) : 6002 - 6011
[39] Pharmacological targeting of PD-L1/PD-1 signaling in gynecological cancers
Farooqi, Ammad Ahmad
Ozbey, Guerkan
Fayyaz, Sundas
Donfrancesco, Cristina
POSTEPY HIGIENY I MEDYCYNY DOSWIADCZALNEJ, 2025, 79 (01): : 25 - 34
[40] PD-L1 and PD-1 in immune regulation and their implications in blood cancers
Aghbash, Parisa Shiri
Mehdizadeh, Faezeh
Pourbeiragh, Ghazal
Yazdani, Yalda
Baghi, Hossein Bannazadeh
Sales, Abolfazl Jafari
Pashazadeh, Mehrdad
Kangari, Parisa
ADVANCES IN CANCER BIOLOGY-METASTASIS, 2024, 11

← 1 2 3 4 5 →