Prognostic role of plasma levels of γ-glutamyl transpeptidase in patients with advanced gastric cancer treated with anti-PD-1 immunotherapy
血浆γ-谷氨酰转肽酶水平在接受抗PD-1免疫治疗的晚期胃癌患者中的预后作用
抗PD-1免疫療法で治療された進行胃癌患者におけるγ-グルタミルトランスペプチダーゼの血漿レベルの予後的役割
항 PD-1 면역 요법으로 치료받은 진행성 위암 환자에서 γ-글루타밀 트랜스펩티다아제의 혈장 수준의 예후 역할
Papel pronóstico de los niveles plasmáticos de γ-glutamil transpeptidasa en pacientes con cáncer gástrico avanzado tratados con inmunoterapia anti-PD-1
Rôle pronostique des taux plasmatiques de γ-glutamyl transpeptidase chez les patients atteints d'un cancer gastrique avancé traités par immunothérapie anti-PD-1
Прогностическая роль уровня γ-глутамилтранспептидазы в плазме у пациентов с распространенным раком желудка, получавших иммунотерапию против PD-1
Shaojie Xu ¹, Yiming Feng 冯一鸣 ², Xingyin Li ¹, Zaozao Huang 黄早早 ³, Hewei Li 李贺伟 ⁴, Ganxin Wang ⁵
¹ First Clinical College, Huazhong University of Science and Technology, Wuhan 430022, China
中国 武汉 华中科技大学第一临床学院
² Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
中国 武汉 华中科技大学同济医学院附属协和医院放射科
³ Yangchunhu Community Hospital, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430077, China
中国 武汉 华中科技大学同济医学院附属梨园医院 杨春湖社区卫生服务中心
⁴ Department of Orthopedics, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430077, China
中国 武汉 华中科技大学同济医学院附属梨园医院 骨外科
⁵ Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
中国 武汉 华中科技大学同济医学院附属协和医院肿瘤中心
Antibodies targeting programmed cell death protein 1 (PD-1) have become the mainstay of treatment for chemotherapy-refractory gastric cancer, characterized by high levels of programmed cell death ligand-1 (PDL-1) expression. However, the routine clinical implementation of PDL-1 testing is currently limited by the lack of robust detection methods. In this regard, the role of plasma γ-glutamyl transpeptidase (GGT), an N-terminal nucleophilic hydrolase, as an independent predictor of the efficacy of anti-PD-1 therapy remains unknown. In this study, we aimed to assessed the prognostic role of changes in plasma GGT levels (6 weeks vs. baseline) in patients with advanced gastric cancer treated with anti-PD-1 immunotherapy.
Methods
We retrospectively analyzed data from 57 patients with gastric cancer treated with anti-PD-1
antibodies (camrelizumab, sintilimab, nivolumab, tislelizumab, and toripalimab) at the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China, from July 2018 to February 2021.
Results
We found that after 6 weeks of treatment, there were significant differences between responders and non-responders with respect to plasma GGT levels (P < 0.001). Multivariate logistic regression analysis revealed that the continuous value of the 6-week difference in GGT levels (OR = 1.437, 95% CI = 1.116–1.849, P = 0.005) and 6-week difference in GGT ≥ 0 or < 0 (OR = 53.675, 95% CI = 6.379–451.669, P < 0.001) were independent predictors of disease control. Survival analysis indicated that a reduction in plasma GGT6 levels during treatment was significantly associated with a favorable progression-free survival (PFS) and overall survival (P < 0.001). Consistently, univariate and multivariate Cox regression analyses revealed that a reduction in plasma GGT6 levels during treatment was an independent predictor
of PFS (HR = 1.033, 95% CI = 1.013–1.053, P = 0.001).
Conclusion
Alterations in plasma GGT levels during treatment can be used as a predictor of disease
progression and survival in patients with advanced gastric cancer undergoing treatment with anti-PD-1 antibodies.
