Pre-Treatment Tumor Growth Rate Predicts Clinical Outcomes of Patients With Advanced Non-Small Cell Lung Cancer Undergoing Anti-PD-1/PD-L1 Therapy.
Pre-Treatment Tumor Growth Rate Predicts Clinical Outcomes of Patients With Advanced Non-Small Cell Lung Cancer Undergoing Anti-PD-1/PD-L1 Therapy.
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治疗前肿瘤生长率可预测接受抗 PD-1/PD-L1 治疗的晚期非小细胞肺癌患者的临床结果
DOI：
10.3389/fonc.2020.621329
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发表时间：
2020
影响因子：
4.7
通讯作者：
Zhang L
中科院分区：
文献类型：
--
作者：
He LN;Zhang X;Li H;Chen T;Chen C;Zhou Y;Lin Z;Du W;Fang W;Yang Y;Huang Y;Zhao H;Hong S;Zhang L
肿瘤生长率（TGR；每月大小变化百分比[%/m]）被假定为抗癌治疗反应的早期影像学预测因子，以克服 RECIST 的局限性。我们的目的是评估治疗前 TGR (TGR0) 对接受抗 PD-1/PD-L1 单药治疗的晚期非小细胞肺癌 (aNSCLC) 患者预后的预测价值。我们回顾性筛选了2016年8月至2018年6月期间在中山大学肿瘤医院接受PD-1轴抑制剂的所有aNSCLC患者。TGR0计算为在开始PD-1轴抑制之前的“清洗”期内两次计算机断层扫描（CT）得出的每月肿瘤大小的百分比变化（%/m）。最终随访日期为2019年8月28日。X-tile程序用于根据最大无进展生存期（PFS）分层确定TGR0的截止值。根据选定的 TGR0 截止值将患者分为两组。主要结局是两组之间 PFS 的差异。采用 Kaplan-Meier 方法和 Cox 回归模型进行生存分析。总共纳入了 80 名符合条件的患者（54 名 [67.5%] 男性；中位年龄 [范围] 55 [30-74] 岁）。中位（范围）TGR0 为 21.1 (-33.7-246.0)%/m。 TGR0的最佳截断值为25.3%/m。高 TGR0 患者的中位 PFS（1.8 个月；95% CI，1.6 - 2.1 个月）比低 TGR0 患者（2.7 个月；95% CI，0.5 - 4.9 个月）短（P = 0.005）。多变量 Cox 回归分析显示，较高的 TGR0 独立预测较差的 PFS（风险比 [HR] 1.97；95% CI，1.08-3.60；P = 0.026）。较高的 TGR0 也与较低的持久临床获益率显着相关（34.8% vs. 8.8%，P = 0.007）。治疗前高 TGR 是接受抗 PD-1/PD-L1 单药治疗的 aNSCLC 患者 PFS 较差和临床获益的可靠预测因子。研究结果强调了 TGR0 作为预测免疫治疗获益的早期生物标志物的作用，并且可以允许调整患者的随访。
Tumor growth rate (TGR; percent size change per month [%/m]) is postulated as an early radio-graphic predictor of response to anti-cancer treatment to overcome limitations of RECIST. We aimed to evaluate the predictive value of pre-treatment TGR (TGR0) for outcomes of advanced non-small cell lung cancer (aNSCLC) patients treated with anti-PD-1/PD-L1 monotherapy. We retrospectively screened all aNSCLC patients who received PD-1 axis inhibitors in Sun Yat-Sen University Cancer Center between August 2016 and June 2018. TGR0 was calculated as the percentage change in tumor size per month (%/m) derived from two computed tomography (CT) scans during a “wash-out” period before the initiation of PD-1 axis inhibition. Final follow-up date was August 28, 2019. The X-tile program was used to identify the cut-off value of TGR0 based on maximum progression-free survival (PFS) stratification. Patients were divided into two groups per the selected TGR0 cut-off. The primary outcome was the difference of PFS between the two groups. The Kaplan-Meier methods and Cox regression models were performed for survival analysis. A total of 80 eligible patients were included (54 [67.5%] male; median [range] age, 55 [30-74] years). Median (range) TGR0 was 21.1 (-33.7-246.0)%/m. The optimal cut-off value of TGR0 was 25.3%/m. Patients with high TGR0 had shorter median PFS (1.8 months; 95% CI, 1.6 - 2.1 months) than those with low TGR0 (2.7 months; 95% CI, 0.5 - 4.9 months) (P = 0.005). Multivariate Cox regression analysis revealed that higher TGR0 independently predicted inferior PFS (hazard ratio [HR] 1.97; 95% CI, 1.08-3.60; P = 0.026). Higher TGR0 was also significantly associated with less durable clinical benefit rate (34.8% vs. 8.8%, P = 0.007). High pre-treatment TGR was a reliable predictor of inferior PFS and clinical benefit in aNSCLC patients undergoing anti-PD-1/PD-L1 monotherapy. The findings highlight the role of TGR0 as an early biomarker to predict benefit from immunotherapy and could allow tailoring patient’s follow-up.
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影响因子：
8.4
作者：
Eisenhauer, E. A.;Therasse, P.;Verweij, J.
通讯作者：
Verweij, J.
影响因子：
--
作者：
Osorio, Benedict;Yegya-Raman, Nikhil;Jabbour, Salma K.
通讯作者：
Jabbour, Salma K.
DOI：
10.1158/1078-0432.ccr-13-2098
发表时间：
2014-01-01
期刊：
Clinical cancer research : an official journal of the American Association for Cancer Research
影响因子：
--
作者：
Ferté C;Fernandez M;Hollebecque A;Koscielny S;Levy A;Massard C;Balheda R;Bot B;Gomez-Roca C;Dromain C;Ammari S;Soria JC
通讯作者：
Soria JC
影响因子：
4.1
作者：
Purcell, Yvonne;Sartoris, Riccardo;Ronot, Maxime
通讯作者：
Ronot, Maxime
影响因子：
11.5
作者：
Champiat, Stephane;Dercle, Laurent;Ferte, Charles
通讯作者：
Ferte, Charles