Inhibition Effect of Pancreatic Exocrine Insufficiency on Immune Checkpoint Inhibitor Treatment in Pancreatic Cancer: A Retrospective Study.

IF 4.4 Q1 IMMUNOLOGY ImmunoTargets and Therapy Pub Date : 2024-02-01 eCollection Date: 2024-01-01 DOI:10.2147/ITT.S442247

Qiankun Luo, Yifei Dong, Pan Liu, Chao He, Lei Chen, Kailun Zhang, Changjie Pan, Yahui Gao, Tao Qin

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Abstract

Introduction: Chemotherapy combined with immune checkpoint inhibitors (ChIM) is used to treat advanced pancreatic ductal adenocarcinoma (PDAC). However, the efficacy of ChIM is similar to that of chemotherapy alone.

Methods: To assess potential factors affecting the effectiveness of ChIM, we analyzed the clinical data of 359 patients with PDAC who visited the hospital during June 2017 to December 2022.

Results: Surgical resection, diabetes, and ChIM were risk factors for pancreatic exocrine insufficiency (PEI). The adjusted odds ratio of ChIM was 2.63 (95% confidence interval (CI) 1.492-4.626) (P = 0.001). The incidence of PEI in the ChIM group (76.9%) was significantly higher than that of the chemotherapy group (60.2%) (P = 0.004). Survival analysis showed that ChIM did not improve the survival rate of patients with PDAC (hazard ratio (HR) 0.92, 0.707-1.197) (P = 0.534) in comparison with that of the chemotherapy group. However, in patients without PEI, those receiving ChIM showed a higher 1-year overall survival (OS) rate of 70.8% (two-sided, P = 0.045) and a median OS of 22.0 months (95% CI 11.5-32.5). Moreover, pancreatic enzyme replacement therapy significantly improved the OS of patients with PDAC (HR = 0.73, 95% CI = 0.561-0.956) (P = 0.022).

Conclusion: Immune checkpoint inhibitors (ICIs) increased the incidence of PEI in patients with PDAC. The OS was not different between patients receiving chemotherapy and ChIM due to irregular PERT treatment. The finding show that pancreatic enzyme replacement therapy may improve the response rate of patients with PDAC to ICIs.

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胰腺外分泌失调对胰腺癌免疫检查点抑制剂治疗的抑制作用：一项回顾性研究

简介：化疗联合免疫检查点抑制剂（ChIM）被用于治疗晚期胰腺导管腺癌（PDAC）。然而，ChIM的疗效与单独化疗相似：为了评估影响ChIM疗效的潜在因素，我们分析了2017年6月至2022年12月期间来院就诊的359例PDAC患者的临床数据：手术切除、糖尿病和ChIM是胰腺外分泌功能不全（PEI）的风险因素。ChIM的调整后几率比为2.63（95%置信区间（CI）为1.492-4.626）（P = 0.001）。ChIM 组的 PEI 发生率（76.9%）明显高于化疗组（60.2%）（P = 0.004）。生存分析显示，与化疗组相比，ChIM 并未改善 PDAC 患者的生存率（危险比 (HR) 0.92，0.707-1.197）（P = 0.534）。然而，在无 PEI 的患者中，接受 ChIM 治疗的患者 1 年总生存率（OS）高达 70.8%（双侧，P = 0.045），中位 OS 为 22.0 个月（95% CI 11.5-32.5）。此外，胰酶替代疗法可显著改善PDAC患者的OS（HR = 0.73，95% CI = 0.561-0.956）（P = 0.022）：结论：免疫检查点抑制剂（ICIs）会增加PDAC患者的PEI发生率。结论：免疫检查点抑制剂（ICIs）增加了PDAC患者PEI的发生率，但由于PERT治疗不规范，接受化疗和ChIM治疗的患者的OS没有差异。研究结果表明，胰酶替代疗法可提高PDAC患者对ICIs的反应率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ImmunoTargets and Therapy IMMUNOLOGY-

CiteScore

16.50

自引率

0.00%

发文量

审稿时长

16 weeks

期刊介绍： Immuno Targets and Therapy is an international, peer-reviewed open access journal focusing on the immunological basis of diseases, potential targets for immune based therapy and treatment protocols employed to improve patient management. Basic immunology and physiology of the immune system in health, and disease will be also covered.In addition, the journal will focus on the impact of management programs and new therapeutic agents and protocols on patient perspectives such as quality of life, adherence and satisfaction.