論文

査読有り 国際誌
2019年4月12日

Retrospective analysis of antitumor effects and biomarkers for nivolumab in NSCLC patients with EGFR mutations

PLOS ONE
  • Miyuki Sato
  • Satoshi Watanabe
  • Hiroshi Tanaka
  • Koichiro Nozaki
  • Masashi Arita
  • Miho Takahashi
  • Satoshi Shoji
  • Kosuke Ichikawa
  • Rie Kondo
  • Nobumasa Aoki
  • Masachika Hayashi
  • Yasuyoshi Ohshima
  • Toshiyuki Koya
  • Riuko Ohashi
  • Yoichi Ajioka
  • Toshiaki Kikuchi
  • 全て表示

14
4
開始ページ
e0215292
終了ページ
e0215292
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1371/journal.pone.0215292
出版者・発行元
Public Library of Science (PLoS)

Although the blockade of programmed cell death 1 (PD-1)/PD-ligand (L) 1 has demonstrated promising and durable clinical responses for non-small-cell lung cancers (NSCLCs), NSCLC patients with epidermal growth factor receptor (EGFR) mutations responded poorly to PD-1/PD-L1 inhibitors. Previous studies have identified several predictive biomarkers, including the expression of PD-L1 on tumor cells, for PD-1/PD-L1 blockade therapies in NSCLC patients; however, the usefulness of these biomarkers in NSCLCs with EGFR mutations has not been elucidated. The present study was conducted to evaluate the predictive biomarkers for PD-1/PD-L1 inhibitors in EGFR-mutated NSCLCs. We retrospectively analyzed 9 patients treated with nivolumab for EGFR-mutated NSCLCs. All but one patient received EGFR-tyrosine kinase inhibitors before nivolumab treatment. The overall response rate and median progression-free survival were 11% and 33 days (95% confidence interval (CI); 7 to 51), respectively. Univariate analysis revealed that patients with a good performance status (P = 0.11; hazard ratio (HR) 0.183, 95% CI 0.0217 to 1.549), a high density of CD4+ T cells (P = 0.136; HR 0.313, 95% CI 0.045 to 1.417) and a high density of Foxp3+ cells (P = 0.09; HR 0.264, 95% CI 0.0372 to 1.222) in the tumor microenvironment tended to have longer progression-free survival with nivolumab. Multivariate analysis revealed that a high density of CD4+ T cells (P = 0.005; HR<0.001, 95% CI <0.001 to 0.28) and a high density of Foxp3+ cells (P = 0.003; HR<0.001, 95% CI NA) in tumor tissues were strongly correlated with better progression-free survival. In contrast to previous studies in wild type EGFR NSCLCs, PD-L1 expression was not associated with the clinical benefit of anti-PD-1 treatment in EGFR-mutated NSCLCs. The current study indicated that immune status in the tumor microenvironment may be important for the effectiveness of nivolumab in NSCLC patients with EGFR mutations.

リンク情報
DOI
https://doi.org/10.1371/journal.pone.0215292
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/30978241
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6461262
URL
http://dx.plos.org/10.1371/journal.pone.0215292
ID情報
  • DOI : 10.1371/journal.pone.0215292
  • eISSN : 1932-6203
  • PubMed ID : 30978241
  • PubMed Central 記事ID : PMC6461262

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