期刊
ESMO OPEN
卷 6, 期 2, 页码 -出版社
ELSEVIER
DOI: 10.1016/j.esmoop.2021.100094
关键词
immune checkpoint inhibitor; chemotherapy; combined timing; PBMC; lung cancer
类别
资金
- National Natural Science Foundation of China, China [81972734, 81972681]
The study explored the impact of combining anti-PD-1 antibody with chemotherapy on cytotoxic effects in peripheral blood mononuclear cells. Results showed that administering the anti-PD-1 Ab 3 days after chemotherapy weakened cytotoxic effects on lymphocytes compared to administration before or concurrent with chemotherapy. Retrospective analysis in refractory lung cancer patients indicated that administering PD-1/PD-L1 inhibitors 1-10 days after chemotherapy, especially 3-5 days after, was associated with longer overall survival.
Background: PD-1/PD-L1 inhibitors in combination with chemotherapy are widely used in clinical practice. However, the ideal combined timing of them has not been fully explored. Methods: In this study, simulation experiments to explore the impacts of the combination of anti-PD-1 antibody (anti-PD-1 Ab) on the cytotoxic effects of chemotherapeutic drugs in peripheral blood mononuclear cells were performed. In addition, the effects of the combined timing of PD-1/PD-L1 inhibitors and chemotherapy on efficacy and safety were retrospectively analysed in patients with refractory lung cancer. Results: Experiments in vitro showed that administering the anti-PD-1 Ab 3 days after chemotherapy (represented by dicycloplatin) resulted in significantly weaker cytotoxic effects on lymphocytes, compared with administering the anti-PD-1 Ab before or concurrent with chemotherapy. Moreover, data from 64 lung cancer patients treated with PD-1/PD-L1 inhibitors plus chemotherapy as a second- or higher-line therapy were retrospectively analysed. The results showed that administering PD-1/PD-L1 inhibitors 1-10 days (especially 3-5 days) after chemotherapy was associated with longer overall survival [17.3 months versus 12.7 months; hazard ratio (HR) = 0.58, 95% confidence interval (CI) 0.28-1.19, P = 0.137 in univariate analysis; HR = 0.36, 95% CI 0.16-0.80, P = 0.012 in multivariate analysis] and a trend of improved progression-free survival (5.1 months versus 4.2 months; HR = 0.81, 95% CI 0.42-1.54, P = 0.512) compared with administering PD-1/PD-L1 inhibitors before or concurrent with chemotherapy. Conclusion: Our findings suggest that administering PD-1/PD-L1 inhibitors 1-10 days (especially 3-5 days) after chemotherapy is superior to administering PD-1/PD-L1 inhibitors before or concurrent with chemotherapy in patients with refractory lung cancer, but this result needs to be further explored by prospective studies.
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