南方医科大学学报

南方医科大学学报 ›› 2022, Vol. 42 ›› Issue (5): 698-704.doi: 10.12122/j.issn.1673-4254.2022.05.10

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非甾体抗炎药对原发性肝癌抗PD-1疗效的影响

李芮宁，黄超艺，洪 畅，王家仁，李绮美，胡诚毅，崔 浩，董忠谊，朱红波，刘 莉，肖芦山   

  1. 南方医科大学南方医院大数据中心，感染科，放疗科，广东 广州 510515；广州第一人民医院感染科，广东 广州 510180；南华大学衡阳医学院第一附属医院肿瘤科，湖南 衡阳 421001
  • 出版日期:2022-05-20 发布日期:2022-06-02

Impact of nonsteroidal anti-inflammatory drugs on efficacy of anti-PD-1 therapy for primary liver cancer

LI Ruining, HUANG Chaoyi, HONG Chang, WANG Jiaren, LI Qimei, HU Chengyi, CUI Hao, DONG Zhongyi, ZHU Hongbo, LIU Li, XIAO Lushan   

  1. Big Data Center, Department of Infectious Diseases, Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China; Department of Infectious Diseases, Guangzhou First People's Hospital, Guangzhou 510180, China; Department of Oncology, First Affiliated Hospital of University of South China, Hengyang 421001, China
  • Online:2022-05-20 Published:2022-06-02

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摘要： 目的 评估非甾体抗炎药（NSAIDs）对接受免疫治疗的肝癌患者临床结局的影响。方法 回顾性分析2018年6月~2020年10月期间接受过免疫治疗的215例原发性肝癌患者。通过倾向性匹配评分，筛选出基线特征基本平衡的病例，根据 1∶3的比例将33例使用NSAIDs的患者与78例未使用NSAIDs的患者匹配成功。统计比较使用NSAIDs组与未使用NSAIDs组的总生存率（OS）、无进展生存率（PFS）、疾病控制率（DCR）的差异。结果 使用 NSAIDs 的患者（29.7%）与未使用 NSAIDs 的患者（70.2%）OS 没有显着差异。单因素与多因素分析未显示 NSAIDs 使用与DCR（单因素分析：优势比（OR），0.602；95%置信区间（CI），0.299~1.213；P=0.156；多因素分析：OR，0.693；95% CI，0.330~1.458；P=0.334）、PFS（单因素分析：风险比（HR），1.230；95% CI，0.789~1.916；P=0.361；多因素分析：HR，1.151；95% CI，0.732~1.810；P=9.544）或 OS（单因素分析：HR，0.552；95%CI，0.208~1.463；P=0.232；多因素分析：HR，1.085；95% CI，0.685~1.717；P=0.729）之间的关联。结论 NSAIDs药物对晚期原发性肝癌患者免疫治疗的效果无有利影响。

关键词: 免疫治疗；原发性肝癌；非甾体抗炎药

Abstract: Objective To assess the impact of nonsteroidal anti-inflammatory drugs (NSAIDs) on clinical outcomes of patients receiving anti-PD-1 immunotherapy for hepatocellular carcinoma. Methods We conducted a retrospective study among 215 patients with primary liver cancer receiving immunotherapy between June, 2018 and October, 2020. The patients with balanced baseline characteristics were selected based on propensity matching scores, and among them 33 patients who used NSAIDs were matched at the ratio of 1∶3 with 78 patients who did not use NSAIDs. We compared the overall survival (OS), progression-free survival (PFS), and disease control rate (DCR) between the two groups. Results There was no significant difference in OS between the patients using NSAIDs (29.7%) and those who did not use NSAIDs (70.2% ). Univariate and multivariate analyses did not show an a correlation of NSAIDs use with DCR (univariate analysis: OR=0.602, 95% CI: 0.299- 1.213, P=0.156; multivariate analysis: OR=0.693, 95% CI: 0.330-1.458, P=0.334), PFS (univariate analysis: HR=1.230, 95% CI: 0.789-1.916, P=0.361; multivariate analysis: HR=1.151, 95% CI: 0.732- 1.810, P=9.544), or OS (univariate analysis: HR=0.552, 95% CI: 0.208-1.463, P=0.232; multivariate analysis: HR=1.085, 95% CI: 0.685-1.717, P=0.729). Conclusion Our results show no favorable effect of NSAIDs on the efficacy of immunotherapy in patients with advanced primary liver cancer, but this finding still needs to be verified by future prospective studies of large cohorts.

Key words: immunotherapy; primary liver cancer; nonsteroidal anti-inflammatory drugs