Оценка параметров иммунного статуса в качестве факторов прогнозирования эффективности терапии в контексте механизмов развития противоопухолевого иммунного ответа

Abstract

The purpose of the study was to evaluate the prognostic and predictive value of lymphocyte subpopulations estimation in the peripheral blood during systemic therapy in patients with solid tumors. Material and methods. We performed a pooled analysis of a series of phase I–II or IV prospective trials conducted in the N.N. Petrov National Medical Research Center of Oncology since 1998 to 2017. Immune system condition (immune status) was assessed 2932 times in 532 patients. 64.5% of patients had melanoma, 16.5% – kidney cancer, 11.4% – soft tissue sarcoma, 7.6% – primary multiple tumors with inclusion of above mentioned diseases. Stages I–II was diagnosed in 12.1% of cases, stage III in 27.5%, stage IV in 60.5%. We present results of the complex assessment of immune factors as predictors of objective response, time to progression or overall survival. Results. We confirmed predictive role of the anergy for efficacy of anticancer vaccines in melanoma. We found several factors that have change their prognostic and predictive value to the opposite in relation to primary tumor, therapy setting (adjuvant or therapeutic), type of therapy. We have shown the efficacy of chemotherapy and targeted therapy in patients with high CD3+CD4+CD24highCD127low lymphocytes level. We have shown favorable prognostic value of elevated CD3+CD4+CD8+ cells level. We demonstrated relation between immune response evaluation and mechanism of action in different types of vaccines. Features of immunological profiles of predictive factors for different diseases, different types of therapy are presented. Conclusion. Evaluation of the main parts of the immune system and allocation of different syndromes is essential for the prediction do the therapy efficacy based on immune system parameters.