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Inflammatory markers tied to better HCC outcomes after nivolumab treatment

26 Nov 2020

Following treatment with nivolumab, a programmed death (PD)-1 inhibitor, the expression of inflammatory markers seems to correlate with better survival and treatment response in hepatocellular carcinoma (HCC) patients, a recent study has shown. This suggests that antitumour inflammatory mechanisms play a role in the action of nivolumab.

A total of 195 pretreatment tumour samples were used in the current analysis. Immunohistochemistry and RNA sequencing were performed to measure biomarkers of inflammation, such as PD-1, PD-ligand 1 (PD-L1), and STAT1, LAG3, and CD8A genes. All samples were from patients who had received a 3-mg/kg dose of nivolumab.

Compared with samples that had PD-L1 expression <1 percent, those with PD-L1 ≥1 percent saw a numerically higher objective response rate (28 percent vs 16 percent). In addition, the proportions of patients who achieved complete (6 percent vs 4 percent) and partial (22 percent vs 12 percent) response were also greater in the PD-L1 ≥1-percent subgroup.

A higher PD-L1 was significantly also associated with better overall survival (OS; p=0.032). Patients with PD-L1 expression ≥1 percent had a median OS of 28.1 months, significantly longer than the 16.6-month survival in counterparts with PD-L1 <1 percent. Higher PD-1 likewise seemed to have a significant effect on OS but was only borderline significant (p=0.05).

In addition, a four-gene signature including markers of inflammation showed significant associations with better objective response rate to treatment (p=0.05) and OS (p=0.01). This gene signature included the CD8A, LAG3, and STAT1 genes, as well as the CD274 gene, which encodes for PD-L1.

“Future biomarker studies may increase understanding of the key molecular drivers of antitumour immunity and continue to support the connection between the mechanism of action of nivolumab and efficacy in HCC,” the researchers said, adding that “larger controlled studies in HCC could also help evaluate the potential predictive/prognostic values of inflammatory biomarkers for nivolumab treatment response.”

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Most Read Articles
10 Jan 2021
Regular practice of yoga postures confers benefits for glucose control, oxidative stress, inflammatory response, and sleep quality in patients with type 2 diabetes, a study has found.
01 Dec 2020
Tetanus toxoid 5 Lf, diphtheria toxoid 2 Lf, pertussis toxoid 2.5 mcg, filamentous haemagglutinin 5 mcg, fimbriae types 2 and 3 5 mcg, pertactin 3 mcg
Dr. Hsu Li Yang, Dr. Tan Thuan Tong, Dr. Andrea Kwa, 08 Jan 2021
Antimicrobial resistance has become increasingly dire as the rapid emergence of drug resistance, especially gram-negative pathogens, has outpaced the development of new antibiotics. At a recent virtual symposium, Dr Hsu Li Yang, Vice Dean (Global Health) and Programme Leader (Infectious Diseases), NUS Saw Swee Hock School of Public Health, presented epidemiological data on multidrug-resistant (MDR) gram-negative bacteria (GNB) in Asia, while Dr Tan Thuan Tong, Head and Senior Consultant, Department of Infectious Diseases, Singapore General Hospital (SGH), focused on the role of ceftazidime-avibactam in MDR GNB infections. Dr Andrea Kwa, Assistant Director of Research, Department of Pharmacy, SGH, joined the panel in an interactive fireside chat, to discuss challenges, practical considerations, and solutions in MDR gram-negative infections. This Pfizer-sponsored symposium was chaired by Dr Ng Shin Yi, Head and Senior Consultant of Surgical Intensive Care, SGH.
Pearl Toh, 26 Nov 2020
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