Background:Previous studies mainly investigated singular serum tumor marker (STM) measurements for the management of advanced cancer patients, resulting in differences between recommended cut-off points and associated accuracies in evaluating treatment outcomes. We aimed to determine which STM dynamics recur during treatment in advanced non-small cell lung cancer (NSCLC) patients with disease control three months after starting with immune checkpoint inhibitor (ICI)-containing treatment and explore whether these dynamics retain information on treatment outcomes.Methods:This real-world exploratory multi-center observational cohort study included advanced NSCLC patients with clinical and radiological disease control three months after starting with ICI-containing treatment and at least three STM measurements for at least one STM during treatment. STM dynamics visualized for all patients were subclassified into three serological response patterns by two investigators who were blinded for treatment outcomes.Results:Between March 2013 and January 2023, 256 patients were included at two thoracic oncology outpatient clinics in The Netherlands. Kaplan–Meier survival analyses showed a significant association between the serological response patterns and both progression-free survival (PFS) and overall survival (OS). Additionally, the serological response patterns could be used to distinguish a durable response versus secondary treatment resistance, and oligoprogression versus systemic progression.Conclusions:Our findings underscore the value of monitoring STM dynamics in advanced NSCLC patients during ICI-containing treatment to improve response classification and decision-making in clinical practice. Future studies should explore the value of the identified dynamics in other tumor- and systemic treatment-types and tumor cell analytes for assessing treatment outcomes across multiple indications.
背景：既往研究主要探讨单一血清肿瘤标志物（STM）测量在晚期癌症患者管理中的应用，导致在评估治疗效果时推荐的截断点及相关准确性存在差异。本研究旨在确定在开始含免疫检查点抑制剂（ICI）治疗三个月后疾病得到控制的晚期非小细胞肺癌（NSCLC）患者中，治疗期间哪些STM动态变化会重复出现，并探讨这些动态是否保留治疗效果信息。 方法：这项真实世界探索性多中心观察性队列研究纳入了开始含ICI治疗三个月后临床和影像学显示疾病得到控制的晚期NSCLC患者，且患者在治疗期间至少对一种STM进行了三次及以上测量。由两位对治疗结果不知情的研究人员将所有患者的STM动态变化可视化，并将其细分为三种血清学反应模式。 结果：2013年3月至2023年1月期间，荷兰两家胸科肿瘤门诊共纳入256例患者。Kaplan-Meier生存分析显示，血清学反应模式与无进展生存期（PFS）和总生存期（OS）均存在显著关联。此外，血清学反应模式可用于区分持久反应与继发性治疗耐药，以及寡进展与系统性进展。 结论：我们的研究结果强调了在含ICI治疗期间监测晚期NSCLC患者STM动态变化的价值，以改善临床实践中的反应分类和决策制定。未来研究应探索已识别的动态变化在其他肿瘤类型、全身治疗类型以及肿瘤细胞分析物中评估多种适应症治疗效果的价值。
肿瘤(癌症)患者之家