本文由小咖机器人翻译整理

期刊来源：Nat Med

原文链接：https://doi.org/10.1038/s41591-024-02929-4

摘要内容如下：

情绪困扰（ED），通常以抑郁和/或焦虑症状为特征，在癌症患者中普遍存在。临床前研究表明，ED可损害抗肿瘤免疫应答，但很少有临床研究探讨其与免疫检查点抑制剂（ICIs）应答的关系。在此，我们报告了前瞻性观察应激-肺研究队列1的结果，该研究调查了ED与晚期非小细胞肺癌患者ICIS一线治疗的临床疗效之间的关系。采用患者健康问卷-9和广泛性焦虑障碍7项量表评估ED。该研究纳入了227名患者，其中111名（48.9%）表现出ED，这些患者在基线时表现出抑郁（患者健康问卷-9评分≥5）和/或焦虑（广泛性焦虑症7项评分≥5）症状。在主要终点分析中，与无ED患者相比，基线ED患者的中位无进展生存期显著缩短（7.9个月对15.5个月，风险比1.73，95%可信区间1.23至2.43，P=0.00 2）。在次要终点分析中，ED与较低的客观缓解率（46.8%对62.1%，比值比0.54，P=0.02 2）、较低的2年总生存率（46.5%对64.9%，死亡风险比1.82，95%可信区间1.12-2.97，P=0.016）和生活质量下降相关。探索性分析表明，ED组血液皮质醇水平升高，这与不良生存结局相关。这项研究表明，接受ICIS治疗的晚期非小细胞肺癌患者的ED与更差的临床结果之间存在关联，突出了在癌症管理中解决ED的潜在意义。ClinicalTrials.gov注册：NCT05477979。

英文原文如下：

Abstracts

Emotional distress (ED), commonly characterized by symptoms of depression and/or anxiety, is prevalent in patients with cancer. Preclinical studies suggest that ED can impair antitumor immune responses, but few clinical studies have explored its relationship with response to immune checkpoint inhibitors (ICIs). Here we report results from cohort 1 of the prospective observational STRESS-LUNG study, which investigated the association between ED and clinical efficacy of first-line treatment of ICIs in patients with advanced non-small-cell lung cancer. ED was assessed by Patient Health Questionnaire-9 and Generalized Anxiety Disorder 7-item scale. The study included 227 patients with 111 (48.9%) exhibiting ED who presented depression (Patient Health Questionnaire-9 score ≥5) and/or anxiety (Generalized Anxiety Disorder 7-item score ≥5) symptoms at baseline. On the primary endpoint analysis, patients with baseline ED exhibited a significantly shorter median progression-free survival compared with those without ED (7.9 months versus 15.5 months, hazard ratio 1.73, 95% confidence interval 1.23 to 2.43, P = 0.002). On the secondary endpoint analysis, ED was associated with lower objective response rate (46.8% versus 62.1%, odds ratio 0.54, P = 0.022), reduced 2-year overall survival rate of 46.5% versus 64.9% (hazard ratio for death 1.82, 95% confidence interval 1.12 to 2.97, P = 0.016) and detriments in quality of life. The exploratory analysis indicated that the ED group showed elevated blood cortisol levels, which was associated with adverse survival outcomes. This study suggests that there is an association between ED and worse clinical outcomes in patients with advanced non-small-cell lung cancer treated with ICIs, highlighting the potential significance of addressing ED in cancer management. ClinicalTrials.gov registration: NCT05477979 .

-----------分割线---------

点击链接：https://www.mediecogroup.com/community/user/vip/categories/ ，成为医咖会员，获取12项专属权益。