亲爱的研友该休息了!由于当前在线用户较少,发布求助请尽量完整的填写文献信息,科研通机器人24小时在线,伴您度过漫漫科研夜!身体可是革命的本钱,早点休息,好梦!

Comparison of the effectiveness of chemotherapy combined with immunotherapy and chemotherapy alone in advanced biliary tract cancer and construction of the nomogram for survival prediction based on the inflammatory index and controlling nutritional status score

医学 列线图 内科学 危险系数 肿瘤科 化疗 单变量分析 置信区间 比例危险模型 胆道癌 免疫疗法 胃肠病学 癌症 多元分析 外科 吉西他滨
作者
Zhengfeng Zhang,Dazhen Wang,Jianji Zhang,Yuli Ruan,Lidan Zhao,Lu Yang,Ze Liu,Lei Yang,Changjie Lou
出处
期刊:Cancer Immunology, Immunotherapy [Springer Nature]
卷期号:72 (11): 3635-3649
标识
DOI:10.1007/s00262-023-03513-4
摘要

Abstract Objective To analyze the effectiveness of combining immune checkpoint inhibitors (ICIs) with first-line therapy in patients with advanced biliary tract cancer (BTC) and explore the biomarkers affecting the prognosis of immunotherapy, to construct a nomogram for the prediction of survival. Methods A retrospective study was conducted to include a total of 209 patients with advanced BTC treated in the first line from 2018 to 2022, divided into a combination therapy group ( n = 129) and a chemotherapy-only group ( n = 80) according to whether ICIs were applied in combination. Univariate and multifactorial COX regression analyses were performed on variables that may affect prognosis to identify independent influences on patient prognosis, and this was used to create nomograms, which were then prospectively validated and calibrated. Results The median progression-free survival (mPFS) and median overall survival (mOS) of patients in the combination therapy group were higher than those in the chemotherapy alone group [hazard ratio (HR) = 1.152, 95% confidence interval (CI): 0.7848–1.692, p = 0.0004, and HR = 1.067, 95% CI: 0.7474–1.524, p = 0.0016]. The objective response rate (ORR) of patients in the combination therapy and chemotherapy alone groups was 39.5% (51/129) vs. 27.5% (22/80), and the disease control rate (DCR) between the two groups was 89.9% (116/129) vs. 83.8% (67/80). Univariate analysis revealed the gender, presence of long-term tobacco and alcohol, degree of histological differentiation, serum albumin level, presence of liver metastases, presence of multi-visceral metastases, response, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), glycoprotein antigen 19-9 (CA19-9), systemic inflammatory index (SII), and controlling nutritional status (CONUT) scores were statistically significant with patient prognosis (all P values < 0.05). Multi-factor COX regression analysis was continued for the above variables, and the results showed that NLR, MLR, PLR, SII, and CONUT scores were independent influences on patients’ OS (all p values < 0.05). A nomogram (C-index 0.77, 95% CI: 0.71–0.84) was created based on these independent influences and later validated using a validation cohort (C-index 0.75, 95% CI: 0.68–0.81). The time-dependent receiver operator characteristic curve (ROC) showed that the area under curve (AUC) of the training cohort patients at 12, 18, and 24 months was 0.72 (95% CI: 0.63–0.81), 0.75 (95% CI: 0.67–0.85), and 0.77 (95% CI: 0.66–0.87) and the AUC of the validation cohort was 0.69 (95% CI: 0.58–0.79), 0.74 (95% CI: 0.65–0.87), and 0.71 (95% CI: 0.64–0.89), respectively. Finally, calibration was performed using calibration curves, and the results showed that nomograms based on inflammatory metrics and CONUT scores could be used to assess survival (12, 18, and 24 months) in patients with advanced BTC treated with ICIs in the first line. Conclusion Patients with advanced BTC benefit more from first-line treatment with standard chemotherapy in combination with ICIs than with chemotherapy alone. In addition, nomograms based on inflammatory metrics and CONUT scores can be used to predict survival at 12, 18, and 24 months in patients with advanced BTC treated with ICIs.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
Tei完成签到,获得积分10
3秒前
5秒前
英俊的铭应助阿a采纳,获得10
46秒前
1分钟前
阿a发布了新的文献求助10
1分钟前
moom完成签到 ,获得积分10
1分钟前
1分钟前
1分钟前
2分钟前
赘婿应助科研通管家采纳,获得30
2分钟前
马梦秋发布了新的文献求助10
2分钟前
2分钟前
2分钟前
2分钟前
充电宝应助欢呼的寻双采纳,获得10
2分钟前
CodeCraft应助泓凯骏采纳,获得10
2分钟前
3分钟前
泓凯骏发布了新的文献求助10
3分钟前
淡定落雁发布了新的文献求助30
3分钟前
淡定落雁完成签到,获得积分10
3分钟前
ninomae完成签到 ,获得积分10
3分钟前
4分钟前
哲别发布了新的文献求助10
4分钟前
5分钟前
5分钟前
哲别发布了新的文献求助10
5分钟前
小二郎应助哲别采纳,获得10
5分钟前
Wish完成签到,获得积分10
5分钟前
菜菜完成签到,获得积分10
6分钟前
7分钟前
菜菜发布了新的文献求助10
7分钟前
Jayden完成签到 ,获得积分10
8分钟前
10分钟前
思源应助科研通管家采纳,获得10
10分钟前
iamzhangly30hyit完成签到 ,获得积分10
10分钟前
lalala大鸭梨完成签到,获得积分10
10分钟前
阿杰完成签到 ,获得积分10
11分钟前
科研通AI2S应助科研通管家采纳,获得10
12分钟前
隐形曼青应助健忘绿茶采纳,获得10
12分钟前
13分钟前
高分求助中
Sustainability in Tides Chemistry 2800
The Young builders of New china : the visit of the delegation of the WFDY to the Chinese People's Republic 1000
Rechtsphilosophie 1000
Bayesian Models of Cognition:Reverse Engineering the Mind 888
Le dégorgement réflexe des Acridiens 800
Defense against predation 800
Very-high-order BVD Schemes Using β-variable THINC Method 568
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3137011
求助须知:如何正确求助?哪些是违规求助? 2787960
关于积分的说明 7784146
捐赠科研通 2444060
什么是DOI,文献DOI怎么找? 1299705
科研通“疑难数据库(出版商)”最低求助积分说明 625497
版权声明 600997