Abstract
The expression levels of CTLA-4 and CD28 were analyzed in 191 nasopharyngeal carcinoma (NPC) patients diagnosed and treated at our hospital between January 2010 and November 2011. The 3-year overall survival (OS) rate (91.4% vs. 81.2%,p = 0.043), failure-free survival (FFS) rate (82.8% vs. 68.0%, p = 0.009) and distant failure-free survival (D-FFS) rate (85.8% vs. 72.3%, p = 0.006) in the low tumor CTLA-4 expression group was higher than in the high tumor CTLA-4 group. There were no differences between the locoregional failure-free survival (LR-FFS) rates in the high and low tumor CTLA-4 expression groups. Moreover, no differences in the OS, FFS, D-FFS, or LR-FFS were observed between the groups with high and low lymphocyte CTLA-4 levels, high and low tumor CD28 levels, or high and low lymphocyte CD28 levels. Cox regression analysis confirmed the prognostic value of tumor CTLA-4 expression, particularly for D-FFS, in NPC patients (p = 0.044). NPC patients with high tumor CTLA-4 expression had a poorer prognosis than those with low expression.
Highlights
Nasopharyngeal carcinoma (NPC) is endemic in southern China and South-East Asia
NPC is one of the Epstein-Barr virus (EBV)associated malignancies with distinct epidemiology, etiology, and clinical biological behavior compared to other head and neck cancers [15]
Identifying the patients who have the potential for immune escape and a greater risk of primary treatment failure is very important
Summary
Nasopharyngeal carcinoma (NPC) is endemic in southern China and South-East Asia. There are approximately 80,000 incident cases and 50,000 deaths annually worldwide, but there are remarkable variations in the racial and geographic distributions [1]. Radiotherapy (RT), intensity-modulated radiotherapy (IMRT), is the recommended treatment for non-metastatic disease [2]. Concurrent chemoradiotherapy (CCRT) with or without adjuvant chemotherapy (AC) is the primary regimen for patients with locoregionally advanced NPC [3, 4]. Patients with similar stages and histological classifications have different survival outcomes due to the heterogeneity of the tumor protein expression profiles. The development of novel tumor markers to stratify treatment outcomes might enable better prediction of patient prognosis, provide insight into the mechanisms responsible for treatment failure, and result in the identification of novel therapeutic targets
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