Serum levels of soluble programmed death ligand 1 predict treatment response and progression free survival in multiple myeloma.
Serum levels of soluble programmed death ligand 1 predict treatment response and progression free survival in multiple myeloma.
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可溶性程序性死亡配体 1 的血清水平可预测多发性骨髓瘤的治疗反应和无进展生存期
DOI：
10.18632/oncotarget.5682
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发表时间：
2015-12-01
期刊：
影响因子：
--
通讯作者：
Lu Y
中科院分区：
文献类型：
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作者：
Wang L;Wang H;Chen H;Wang WD;Chen XQ;Geng QR;Xia ZJ;Lu Y
免疫检查点信号在多发性骨髓瘤（MM）的免疫抑制中起重要作用。可溶性程序性死亡配体1（sPD - L1）是一种与检查点相关的蛋白质，其血液水平可能预测MM患者的治疗反应和生存结果。我们采用酶联免疫吸附测定法测量了81例新诊断的MM患者的血清sPD - L1水平。我们发现骨髓瘤患者的sPD - L1浓度高于健康对照组。预测疾病进展风险的最佳sPD - L1截断值为2.783 ng/mL。低sPD - L1水平患者对治疗的总体反应率高于高sPD - L1水平患者。所有患者的3年无进展生存率（PFS）和总生存率（OS）分别为16%和64%。包括东部肿瘤协作组体能状态评分、治疗反应和sPD - L1水平在内的多变量生存分析表明，治疗反应低于部分缓解（PR）以及较高的sPD - L1水平（>2.783 ng/ml）是PFS较短的独立预后因素；这两个因素均不能预测OS。血清sPD - L1水平是预测治疗反应的有价值的生物标志物，也是PFS的独立预后因素。PD - 1/PD - L1阻断可能是MM中一种有前景的基于免疫的新型治疗策略。
Immune checkpoint signaling plays an important role in immunosuppression in multiple myeloma (MM). Blood levels of soluble programmed death-ligand 1 (sPD-L1), a checkpoint-relevant protein, might predict treatment response and survival outcomes in MM patients. We used an enzyme-linked immunosorbent assay to measure serum sPD-L1 levels in 81 newly diagnosed MM patients. We found that myeloma patients had higher sPD-L1 concentrations than healthy controls. The best sPD-L1 cutoff value for predicting disease progression risk was 2.783 ng/mL. The overall response rate to treatment was higher in low sPD-L1 patients than in high sPD-L1 patients. The 3-year progression free survival (PFS) and overall survival (OS) rates for all patients were 16% and 64%, respectively. Multivariate survival analysis including Eastern Cooperative Oncology Group performance status score, treatment response, and sPD-L1 level showed that a less than partial treatment response (PR) and higher sPD-L1 levels (>2.783 ng/ml) were independent prognostic factors for shorter PFS; neither factor was predictive of OS. The serum sPD-L1 level is a valuable biomarker for predicting treatment response and an independent prognostic factor for PFS. PD-1/PD-L1 blockade may be a promising novel immune-based therapeutic strategy in MM.