Using peripheral blood indicators and T cells subsets to evaluate the efficacy of immunotherapy for advanced and recurrent cervical cancer.

چکیده اصلی

To identify predictive biomarkers for immunotherapy response in advanced/recurrent cervical cancer by evaluating peripheral blood indicators including T-cell subsets and serum biomarkers. This prospective study (June 2022-July 2024) enrolled 50 patients with stage III-IVa or recurrent cervical cancer receiving first-line immunotherapy combined with chemo/radiotherapy from Qingdao Central Hospital network. We analyzed baseline CD4+/CD8+ T-cell percentages and post-treatment (after one course) levels of CA125, SCCA, T-cell subsets, and PD-1 expression on T-cells using logistic regression (treatment efficacy，comparing 36 responders vs. 14 non-responders) and Cox regression (prognosis, with disease progression or death events occurring in 26 patients). Treatment response was significantly associated with: (1) baseline CD4+ T-cell percentage and (2) post-treatment CA125/SCCA levels, CD8+ T-cell percentage, and PD-1 expression on both CD4+/CD8+ T-cells (all p < .05). Prognostic factors identified by Cox regression included these same markers plus post-treatment CD4+ T-cell percentage. Optimal responders showed: high baseline CD4+ T-cells, low post-treatment CA125/SCCA, elevated CD4+/CD8+ T-cells, and reduced PD-1 expression. Peripheral T-cell subsets and serum biomarkers show significant associations with predicted immunotherapy outcomes. High baseline CD4+ T-cells with post-treatment normalization of immune markers (increased T-cells, decreased PD-1+ cells, and tumor antigens) are associated with a higher likelihood of benefiting from immunotherapy. It should be noted that this study has limitations, including a modest sample size and the assessment of biomarkers at only a single post-treatment time point, which may affect the generalizability of the findings. These peripheral blood biomarkers may represent a minimally invasive approach for exploring treatment dynamics and are considered worthy of further investigation as potential adjuncts in the context of personalized immunotherapy for advanced cervical cancer. However, their predictive performance and clinical utility remain to be validated in larger, independent cohorts before any clinical application can be considered.

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