Background: The immunotherapy of head and neck cancer induces a limited rate of long-term survivors at the cost of treating many patients exposed to toxicity without benefit, regardless of PD-L1 expression. The identification of better biomarkers is warranted. We analyzed a panel of cytokines, chemokines and growth factors, hereinafter all referred to as ‘cytokines’, as potential biomarkers in patients with head and neck cancer treated with nivolumab. Materials and methods: A total of 18 circulating cytokines were analyzed. Samples were gathered at baseline (T0) and after 3 courses of nivolumab (T1) in patients with relapsed/metastatic disease. The data extracted at T0 were linked to survival; the comparison of T0–T1 explored the effect of immunotherapy. Results: A total of 22 patients were accrued: 64% current heavy smokers, 36% female and 14% had PS = 2. At T0, ROC analysis showed that IL-6, IL-8, IL-10 and TGF-β were higher in patients with poor survival. Cox analysis demonstrated that only patients with the IL-6 and TGF-β discriminate had good or poor survival, respectively. Longitudinal increments of CCL-4, IL-15, IL-2 and CXCL-10 were observed in all patients during nivolumab treatment. Conclusion: In this small population with poor clinical characteristics, this study highlights the prognostic role of IL-6 and TGF-β. Nivolumab treatment is associated with a positive modulation of some Th1 cytokines, but it does not correlate with the outcome.
背景：头颈癌的免疫治疗虽能带来一定比例的长期生存者，但代价是许多患者承受治疗毒性却未获益，且这一现象与PD-L1表达水平无关。因此有必要寻找更优的生物标志物。本研究分析了一系列细胞因子、趋化因子和生长因子（下文统称为“细胞因子”）作为接受纳武利尤单抗治疗的头颈癌患者的潜在生物标志物。 材料与方法：共检测了18种循环细胞因子。样本采集自复发/转移性疾病患者接受纳武利尤单抗治疗前（T0）及完成3个疗程后（T1）。T0时提取的数据与生存期相关联；T0-T1的对比分析用于探索免疫治疗效应。 结果：共纳入22例患者：64%为当前重度吸烟者，36%为女性，14%体力状态评分（PS）=2。T0时ROC分析显示，生存期较差患者的IL-6、IL-8、IL-10和TGF-β水平更高。Cox分析表明，仅IL-6和TGF-β具有生存预后区分能力，分别对应良好与不良预后。在纳武利尤单抗治疗期间，所有患者均观察到CCL-4、IL-15、IL-2和CXCL-10的纵向升高。 结论：在这项临床特征较差的小样本研究中，IL-6和TGF-β显示出重要预后价值。纳武利尤单抗治疗与部分Th1细胞因子的正向调节相关，但这种调节与临床结局无显著相关性。
肿瘤(癌症)患者之家