Organ-Specific Differences in Immunotherapy Response Among Metastatic Cancer Patients
Real-world Evidence and Multi-omics Insights Into Differential Immunotherapy Responses Between Primary and Metastatic Sites
This study examines how tumors in different metastatic organs respond to immune checkpoint inhibitor (ICB) therapy in real-world clinical practice. ICB therapy helps the immune system recognize and attack cancer cells, but treatment responses may vary depending on where the cancer has spread. Common metastatic sites such as the liver, brain, lung, and bone each have unique immune environments that may influence treatment outcomes.
The investigators will review the medical records of approximately 1,000 adults with solid tumors who received ICB therapy at Sun Yat-sen Memorial Hospital, the Third Affiliated Hospital of Sun Yat-sen University, and the First Affiliated Hospital of Chongqing Medical University since 2016. The study will compare treatment response, time until disease progression, and overall survival among patients with different metastatic sites. Additional outcomes include disease control, immunotherapy-related side effects, and concordance between primary and metastatic tumor responses.
The study will also analyze available molecular and immune-profiling datasets to explore biological mechanisms that may explain organ-specific differences in ICB response. The goal is to improve understanding of how metastatic sites influence immunotherapy effectiveness and to support future treatment decision-making.
調査の概要
研究の種類
入学 (実際)
連絡先と場所
研究場所
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Guangdong
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Guangzhou、Guangdong、中国
- Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University
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参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- Age ≥18 years.
- Pathologically confirmed solid tumor with a documented primary tumor site.
- At least one metastatic site in the brain, liver, lung, or bone confirmed by imaging or pathology (single or multiple lesions allowed).
- Received first-line or second-line immune checkpoint inhibitor (ICB) therapy, including PD-1, PD-L1, or CTLA-4 inhibitors, either alone or in combination.
- Completed at least 3 cycles of ICB therapy.
- At least one evaluable imaging follow-up after initiation of immunotherapy.
- Available clinical and follow-up data, including treatment initiation date, response assessment, progression status, and survival status.
- Meets institutional ethics requirements for retrospective studies.
Exclusion Criteria:
- Unclear or undocumented metastatic site, or lack of imaging/pathologic evidence supporting metastasis.
- ICB treatment regimen cannot be clearly determined (e.g., unclear combination therapy components).
- Missing more than 20% of key clinical variables or incomplete follow-up data (e.g., missing PFS or OS information).
- Received fewer than 3 cycles of ICB therapy.
- Major treatment interruption or poor treatment adherence.
- Concurrent active malignancy that may interfere with outcome assessment.
- Severe immune-related disease (e.g., systemic lupus erythematosus) or organ transplantation requiring long-term immunosuppression.
- Participation in another interventional clinical trial that may affect treatment evaluation.
- Data errors or logical inconsistencies that cannot be resolved after review.
研究計画
研究はどのように設計されていますか？
デザインの詳細
コホートと介入
グループ/コホート |
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Metastatic cancers treated with immune checkpoint inhibitors
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
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Organ-Specific Objective Response Rate (osORR)
時間枠：At first radiographic assessment after immunotherapy initiation (approximately 6-12 weeks).
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osORR is the percentage of patients whose tumors in a specific metastatic organ (brain, liver, lung, or bone) achieve a complete response (CR) or partial response (PR) following immunotherapy, as assessed according to RECIST v1.1.
Each metastatic organ is evaluated separately.
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At first radiographic assessment after immunotherapy initiation (approximately 6-12 weeks).
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Organ-Specific Progression-Free Survival (osPFS)
時間枠：Up to 5 years.
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osPFS is defined as the time from initiation of immunotherapy to disease progression within the specific metastatic organ or death from any cause, whichever occurs first.
Progression is assessed according to RECIST v1.1 based on target lesions within the corresponding organ, regardless of progression occurring in other organs.
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Up to 5 years.
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Overall Survival (OS)
時間枠：From start of ICB treatment until death from any cause (up to 5 years).
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In this retrospective study, OS is defined as the time from initiation of immune checkpoint blockade (ICB) therapy to death from any cause.
Survival time is determined using available longitudinal follow-up records.
Patients who are alive at the last follow-up will be censored.
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From start of ICB treatment until death from any cause (up to 5 years).
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協力者と研究者
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。