Peripheral blood lymphocyte subsets predict the efficiency of TACE with or without PD-1 inhibitors in patients with hepatocellular carcinoma: a prospective clinical study
Description
Methods: We prospectively enrolled 157 patients with hepatocellular carcinoma (HCC) treated with transcatheter arterial chemoembolization (TACE) combined with or without PD-1 inhibitors. Twenty peripheral lymphocyte subsets and cytokines were analyzed. We analyzed the differences in PD-1+ T cells between patients treated with and without PD-1 inhibitors and their association with tumor response, survival prognosis, and clinical features. Results: Baseline CD8+PD-1+ and CD4+PD-1+ T-cell frequencies in patients who had undergone PD-1 inhibitors were lower than those in in patients who had not undergone PD-1 inhibitors (p<0.001). In the former, there was no difference in PD-1+ T-cell frequencies between the responder and non-responder subgroups (p>0.05). In the latter, the levels of CD8+PD-1+ T cells, CD4+PD-1+ T cells, and their ratio did not predict tumor response, progression-free survival (PFS), or overall survival (OS) (p>0.05). Furthermore, in multivariate analysis, in patients treated with and without PD-1 inhibitors, the levels of CD8+CD38+/CD8+ T cells (OR=2.806, p=0.006) were associated with tumor response; those of CD8+CD28+/CD8+ T cells (p=0.038, p=0.027) and natural killer (NK) cells (p=0.01, p=0.001) were associated with PFS and OS. These independent prognostic factors were related to progressive tumor characteristics (p<0.05); however, their changes before and after treatment were not associated with tumor response (p>0.05), except for CD8+CD28+/CD8+ T cells.