Effect of bevacizumab assisted PD-1 inhibitor on serum miR-20a-5p and miR-515-3p in the treatment of gastric cancer

doi:10.19401/j.cnki.1007-3639.2024.05.006

Abstract

Abstract:

Background and purpose: Second-line chemotherapy is not effective in the treatment of gastric cancer. Bevacizumab is a molecularly targeted anticancer drug, and sindilizumab is a domestic programmed death-1 (PD-1) inhibitor. The combination of the two is a new direction for clinical treatment of gastric cancer. This study aimed to analyze the effects of bevacizumab assisted PD-1 inhibitor in the treatment of gastric cancer on serum miR-20a-5p and miR-515-3p. Methods: A retrospective study was conducted on 84 patients with gastric cancer treated in the Fourth Affiliated Hospital of Nanjing Medical University from January 2019 to July 2021, and they were divided into the observation group and the control group with 42 cases each according to different treatment plans. The control group was given second-line chemotherapy, and the observation group was given bevacizumab combined with PD-1 inhibitor (sindilizumab) on the basis of the control group. objective response rate (ORR), disease control rate (DCR), serum tumor markers, immune function indexes, serum miR-20a-5p and miR-515-3p levels and total incidence of toxic and side effects were compared between the two groups. This study has been approved by the Ethics Committee of the Fourth Affiliated Hospital of Nanjing Medical University (approval number: 20230531--K061). Results: The ORR (69.05%) and DCR (85.71%) of the observation group were higher than those of the control group (40.48% and 64.29%), and the difference was statistically significant (P<0.05). After treatment, serum carbohydrate antigen 12-5 (CA12-5), carcinoembryonic antigen (CEA) and cytokerantin-19-fragment antigen 21-1 (CYFRA21-1) levels were lower in observation group than in control group (P<0.05). CD4⁺ T lymphocyte and CD4⁺/CD8⁺ T lymphocyte ratio were higher in observation group than in control group after treatment (P<0.05), and CD8⁺ T lymphocyte was lower in observation group than in control group after treatment (P<0.05). After treatment, the serum levels of miR-20a-5p and miR-515-3p were lower in the observation group than in the control group (P<0.05). There was no significant difference in total incidence of adverse effects between the observation group (28.57%) and the control group (38.10%) (P>0.05). Conclusion: Bevacizumab assisted sindilizumab can effectively improve the treatment efficiency of gastric cancer, improve immune function, and reduce the expression levels of serum miR-20a-5p, miR-515-3p and tumor markers, without increasing toxic and side effects.

Key words: Bevacizumab, Programmed death-1 inhibitor, Gastric cancer, miR-20a-5p, miR-515-3p

CLC Number:

R735.2

WANG Fei, LIU Pei, HU Nan. Effect of bevacizumab assisted PD-1 inhibitor on serum miR-20a-5p and miR-515-3p in the treatment of gastric cancer[J]. China Oncology, 2024, 34(5): 493-500.

Figures/Tables 6

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References 38

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General information	Observation group	Control group	χ²/t value	P value
Gender			0.048	0.826
Male	22 (52.38)	24 (57.14)
Female	20 (47.62)	18 (42.86)
Differentiation degree			0.254	0.614
Medium-high differentiation	33 (78.57)	30 (71.43)
Poor differentiation	9 (21.43)	12 (28.57)
TNM stage			0.051	0.822
Stage Ⅲ	17 (40.48)	15 (35.71)
Stage Ⅳ	25 (59.52)	27 (64.29)
Lymph node metastasis			0.071	0.790
Yes	8 (19.02)	10 (23.81)
No	34 (80.95)	32 (76.19)
Pathological type			0.193	0.908
Mucinous adenocarcinoma	13 (30.95)	12 (28.57)
Papillary adenocarcinoma	18 (42.86)	20 (47.62)
Adeno-squamous carcinoma	11 (26.19)	10 (23.81)
Age/year $\bar{x} \pm s$	49.62±7.66	49.52±8.16	0.058	0.954
Focal diameter/cm $\bar{x} \pm s$	4.85±1.02	4.79±1.16	0.252	0.802
BMI/(kg·m^-2) $\bar{x} \pm s$	24.62±1.35	24.88±1.41	0.863	0.391

Group	Observation group	Control group	χ²/t value	P value
CR	11 (26.19)	6 (14.29)
PR	18 (42.86)	11 (26.19)
SD	7 (16.67)	10 (23.81)
PD	6 (14.29)	15 (35.71)
ORR	29 (69.05)	17 (40.48)	6.920	0.009
DCR	36 (85.71)	27 (64.29)	5.143	0.023

Group	Case n	Observation group	Control group	t value	P value
CA12-5/(U·mL^-1)	Before treatment	68.62±5.05	69.01±5.28	0.346	0.730
	After treatment	26.11±2.85^a	48.31±4.15^a	28.578	0.000
CEA/(ng·mL^-1)	Before treatment	91.62±8.26	92.11±8.96	0.261	0.795
	After treatment	45.62±5.26^a	70.82±7.11^a	18.466	0.000
CYFRA21-1/(ng·mL^-1)	Before treatment	10.38±2.62	10.44±2.56	0.106	0.916
	After treatment	2.16±1.62^a	5.92±1.84^a	9.940	0.000

Group	Case n	Observation group	Control group	t value	P value
CD4^{+ T lymphocyte}/%	Before treatment	28.62±3.66	28.52±3.95	0.120	0.905
	After treatment	42.58±5.64^a	36.28±4.16^a	5.826	0.000
CD8^{+ T lymphocyte}/%	Before treatment	38.62±5.55	38.71±5.29	0.076	0.940
	After treatment	29.13±1.52^a	33.05±2.85^a	7.865	0.000
CD4⁺/CD8^{+ T lymphocyte ratio}	Before treatment	0.75±0.11	0.78±0.12	1.194	0.236
	After treatment	1.43±0.34^a	1.11±0.19^a	5.325	0.000

Group	Case n	Observation group	Control group	t value	P value
miR-20a-5p	Before treatment	0.71±0.13	0.74±0.15	0.979	0.330
	After treatment	0.48±0.10^a	0.55±0.12^a	2.904	0.005
miR-515-3p	Before treatment	2.41±0.34	2.45±0.29	0.580	0.563
	After treatment	1.02±0.11^a	1.68±0.13^a	25.117	0.000