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Treatment efficacy of PD-1 inhibitor and its effect on the level of T lymphocyte subsets and cytokine in peripheral blood of patients with advanced lung cancer
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Abstract:
Objective: To explore the efficacy of PD-1 inhibitors in the treatment of patients with advanced lung cancer and its influence on the T lymphocyte subsets and cytokine levels in the peripheral blood of patients. Methods: A total of 50 patients with lung cancer admitted to Haikou Hospital from August 2018 to December 2020 were selected, and 50 healthy subjects were selected as control. The expression of PD-1 expression in lung cancer tissues was detected by immunohistochemistry. Lung cancer patients were treated with nivolumab or pembrolizumab, and venous blood was collected at one day before treatment, the end of treatment cycle 1,and the end of treatment cycle 4. After 4 cycles of treatment, CT or MRI was performed to evaluate the tumor size. Patients evaluated with complete response (CR), partial response (PR), and stable disease (SD) were classified as an immune responsive group, and patients evaluated with progressive disease (PD) were classified as an immune non-responsive group. The effect of PD-1 inhibitor treatment on T lymphocyte subsets (CD3+T, CD4+T, CD8+T, CD4+/CD8+T, Treg, and Th1/Th2 cells), NK cells, cytokines (IFN-γ, IL-2,IL-4, and IL-5) in peripheral blood of patients were evaluated. Results: Compared with healthy controls, the levels of CD3+T, CD4+T,CD4+/CD8+T, Th1/Th2 cells, IFN-γ, and IL-2 in peripheral blood of lung cancer patients were significantly decreased, while the levels of CD8+ T cells, Treg cells, NK cells, IL-4, and IL-5 were significantly increased (all P<0.05). Compared with pre-treatment, the levels of CD3+T, CD4+T, CD4+/CD8+T cells were significantly increased, while the levels of CD8+T cells, Treg cells, and NK cells were significantly decreased after 1 and 4 cycles of treatment (all P<0.05). After 4 cycles of treatment, there were 40 cases in the immune responsive group and 10 cases in the non-immune responsive group, with an effective rate of 80%. Compared with the immune non[1]responsive group, the levels of CD3+T, CD4+T, CD4+/CD8+T, and Th1/Th2 cells were significantly increased in the immune response group, while the levels of CD8+T cells, Treg cells, and NK cells were significantly decreased (all P<0.05); In the immune responsive group, there were 32 patients with high PD-L1 expression (≥50%) and 8 patients with low PD-L1 expression (<50%). Compared with patients with low PD-L1 expression, the levels of CD3+T, CD4+T, CD4+/CD8+T cells were significantly increased in patients with high PD-L1 expression, while the levels of CD8+T cells, Treg cells, and NK cells were significantly decreased (all P<0.05). Conclusion: Nivolumab or pembrolizumab treatment can affect the distribution of immune cells such as T lymphocyte subsets in patients with advanced lung cancer and improve the immune status of patients.
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Project Supported:
Project supported by the Health Industry Research Project of Hainan Province (No. 20A200355)
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