Helicobacter pylori and immunotherapy for gastrointestinal cancer

作者：Keren Jia, Yang Chen, Yi Xie, Xicheng Wang, Yajie Hu, Yu Sun, Yanshuo Cao, Liyan Zhang, Yakun Wang, Zhenghang Wang, Zhihao Lü, Jian Li, Xiaotian Zhang, Lin Shen · 发表于：The Innovation · 年份：2024 · DOI：10.1016/j.xinn.2023.100561 · 被引用次数：49 · 研究领域：Helicobacter pylori-related gastroenterology studies、Gastric Cancer Management and Outcomes、Colorectal and Anal Carcinomas

Helicobacter pylori infection is associated with the risk of gastrointestinal (GI) cancers; however, its impact on immunotherapy for GI cancers remains uncertain. In this study, we included 10,122 patients who underwent 13 C-urea breath tests. Among 636 patients with Epstein-Barr virus–negative microsatellite-stable gastric cancer (GC) who were treated with anti-PD-1/PD-L1 therapy, H. pylori –positive patients exhibited significantly longer immune-related progression-free survival (irPFS) compared with H. pylori –negative patients (6.97 months versus 5.03 months, p < 0.001, hazard ratio [HR] 0.76, 95% confidence interval [CI] 0.62–0.95, p = 0.015). Moreover, the H. pylori –positive group demonstrated a trend of 4 months longer median immune-related overall survival (irOS) than the H. pylori –negative group. H. pylori –positive GC displayed higher densities of PD-L1 + cells and nonexhausted CD8 + T cells, indicative of a "hot" tumor microenvironment. Transcriptomic analysis revealed that H. pylori –positive GC shared molecular characteristics similar to those of immunotherapy-sensitive GC. However, H. pylori –positive patients with DNA mismatch repair–deficient (dMMR)/microsatellite instability–high (MSI-H) colorectal adenocarcinoma and esophageal squamous cell carcinoma (ESCC) had shorter irPFS compared with H. pylori –negative patients (16.13 months versus not reached, p = 0.042, HR 2.26, 95% CI 1.13–4.50, p = 0.021 and 5.57 months versus 6.97 months, p = 0.029, HR 1.59, 95%...