预测复发性或转移性头颈部鳞状细胞癌患者抗 PD-1 疾病控制情况的基于 RNA 的检测方法的多中心验证:PREDAPT 研究。

IF 10.3 1区 医学 Q1 IMMUNOLOGY Journal for Immunotherapy of Cancer Pub Date : 2024-11-03 DOI:10.1136/jitc-2024-009573
Kevin C Flanagan, Jon Earls, Jeffrey Hiken, Rachel L Wellinghoff, Michelle M Ponder, Howard L McLeod, William H Westra, Vera Vavinskaya, Leisa Sutton, Ida Deichaite, Orlan K Macdonald, Karim Welaya, James Wade, Georges Azzi, Andrew W Pippas, Jennifer Slim, Bruce Bank, Xingwei Sui, Steven E Kossman, Todd D Shenkenberg, Warren L Alexander, Katharine A Price, Jessica Ley, David N Messina, Jarret I Glasscock, A Dimitrios Colevas, Ezra E W Cohen, Douglas Adkins, Eric J Duncavage
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引用次数: 0

摘要

背景:尽管癌症治疗和检测技术不断进步,但头颈部鳞状细胞癌(HNSCC)患者中仍有超过 65% 的患者会出现复发和/或转移性疾病。这些患者的预后很差,5年总生存率仅为39%。免疫疗法(包括免疫检查点抑制剂,如 pembrolizumab 和 nivolumab)的最新治疗进展使一部分患者获得了临床获益。方法:在此,我们报告了一项多中心观察性研究 "从治疗前肿瘤活检分析预测免疫疗法疗效"(PREDAPT)的结果,该研究在美国 17 个医疗保健系统中开展。PREDAPT旨在验证OncoPrism-HNSCC,这是一种临床生物标记物检测方法,可预测接受抗PD-1免疫检查点抑制剂单药(单药疗法)或联合化疗(化疗免疫疗法)治疗的复发性或转移性HNSCC患者的疾病控制情况。该测试使用RNA测序数据和机器学习模型对每位患者进行评分,并将其分为低、中或高组:结果:OncoPrism-HNSCC预测结果与单药治疗队列(62人,P=0.004)和化疗免疫治疗队列(50人,P=0.01)的疾病控制率显著相关。OncoPrism-HNSCC 还能显著预测两个队列的无进展生存期(分别为 p=0.015 和 p=0.037)。在预测疾病控制方面,OncoPrism-HNSCC的特异性比程序性死亡配体1联合阳性评分高出三倍多,灵敏度比肿瘤突变负荷高出近四倍:在此,我们证明了OncoPrism-HNSCC测定在识别抗PD-1免疫检查点抑制剂反应的疾病控制患者方面的临床有效性:NCT04510129.
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Multicenter validation of an RNA-based assay to predict anti-PD-1 disease control in patients with recurrent or metastatic head and neck squamous cell carcinoma: the PREDAPT study.

Background: Despite advances in cancer care and detection, >65% of patients with squamous cell cancer of the head and neck (HNSCC) will develop recurrent and/or metastatic disease. The prognosis for these patients is poor with a 5-year overall survival of 39%. Recent treatment advances in immunotherapy, including immune checkpoint inhibitors like pembrolizumab and nivolumab, have resulted in clinical benefit in a subset of patients. There is a critical clinical need to identify patients who benefit from these antiprogrammed cell death protein 1 (anti-PD-1) immune checkpoint inhibitors.

Methods: Here, we report findings from a multicenter observational study, PREDicting immunotherapy efficacy from Analysis of Pre-treatment Tumor biopsies (PREDAPT), conducted across 17 US healthcare systems. PREDAPT aimed to validate OncoPrism-HNSCC, a clinical biomarker assay predictive of disease control in patients with recurrent or metastatic HNSCC treated with anti-PD-1 immune checkpoint inhibitors as a single agent (monotherapy) and in combination with chemotherapy (chemo-immunotherapy). The test used RNA-sequencing data and machine learning models to score each patient and place them into groups of low, medium, or high.

Results: The OncoPrism-HNSCC prediction significantly correlated with disease control in both the monotherapy cohort (n=62, p=0.004) and the chemo-immunotherapy cohort (n=50, p=0.01). OncoPrism-HNSCC also significantly predicted progression-free survival in both cohorts (p=0.015 and p=0.037, respectively). OncoPrism-HNSCC had more than threefold higher specificity than programmed death-ligand 1 combined positive score and nearly fourfold higher sensitivity than tumor mutational burden for predicting disease control.

Conclusions: Here, we demonstrate the clinical validity of the OncoPrism-HNSCC assay in identifying patients with disease control in response to anti-PD-1 immune checkpoint inhibitors.

Trial registration number: NCT04510129.

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来源期刊
Journal for Immunotherapy of Cancer
Journal for Immunotherapy of Cancer Biochemistry, Genetics and Molecular Biology-Molecular Medicine
CiteScore
17.70
自引率
4.60%
发文量
522
审稿时长
18 weeks
期刊介绍: The Journal for ImmunoTherapy of Cancer (JITC) is a peer-reviewed publication that promotes scientific exchange and deepens knowledge in the constantly evolving fields of tumor immunology and cancer immunotherapy. With an open access format, JITC encourages widespread access to its findings. The journal covers a wide range of topics, spanning from basic science to translational and clinical research. Key areas of interest include tumor-host interactions, the intricate tumor microenvironment, animal models, the identification of predictive and prognostic immune biomarkers, groundbreaking pharmaceutical and cellular therapies, innovative vaccines, combination immune-based treatments, and the study of immune-related toxicity.
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