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已发表论文
胸腺肽α1联合PD-1/PD-L1抑制剂及化疗治疗铂耐药复发性卵巢癌：一项回顾性分析
Authors Wang H, Wang L, Zhong H, Li Z
Received 25 May 2025
Accepted for publication 19 November 2025
Published 2 December 2025 Volume 2025:17 Pages 2997—3004
DOI https://doi.org/10.2147/CMAR.S542744
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Chien-Feng Li
Hong Wang,1 Lixia Wang,1 Heqing Zhong,1 Zhendong Li2
1Department of Obstetrics and Gynecology, Neijiang Maternal and Child Health Hospital, Neijiang, Sichuan, People’s Republic of China; 2Orthopedic Department, the Second People’s Hospital of Neijiang, Neijiang, Sichuan, People’s Republic of China
Correspondence: Zhendong Li, Orthopedic Department, the Second People’s Hospital of Neijiang, Neijiang, Sichuan, People’s Republic of China, Email 15282193909@163.com
Background: Platinum-resistant recurrent ovarian cancer remains a major therapeutic challenge. Immune checkpoint inhibitors (ICIs) combined with chemotherapy are widely used, but clinical benefits remain limited. Thymosin α 1 (Tα 1), an immunomodulatory peptide, may synergize with ICIs to enhance anti-tumor immunity.
Methods: This retrospective study included 386 patients with PROC, with 193 patients receiving Tα 1 combined with PD-1/PD-L1 inhibitors and chemotherapy (experimental group), and 193 patients receiving PD-1/PD-L1 inhibitors and chemotherapy alone (control group). Baseline clinical characteristics, clinical efficacy, immune parameters, progression-free survival (PFS), and adverse events were compared between the two groups. Kaplan–Meier survival analysis and multivariate Cox proportional hazards regression were used to assess PFS and associated prognostic factors. Continuous and categorical variables were compared using t-test and χ2-test, respectively. Statistical significance was defined as p < 0.05.
Results: Baseline characteristics were comparable between the two groups. The experimental group showed significantly higher objective response rate (43% vs 30.2%; p = 0.008) and disease control rate (87% vs 69.8%; p = 0.000). The median PFS was significantly longer in the experimental group (3.0 vs 1.1 months; HR = 3.22, 95% CI: 2.59– 4.01; p = 0.000). Post-treatment, patients in the experimental group demonstrated significantly elevated levels of IgA, IgG, IgM, CD3+, CD4+, CD4+/CD8+ ratio, and NK cells compared to the control group (all p < 0.01), while CD8 levels remained similar. The incidence of adverse events was lower in the experimental group (50.8% vs 65.8%; χ2 = 8.35, p = 0.004), primarily due to a reduced rate of myelosuppression.
Conclusion: The addition of Tα 1 to PD-1/PD-L1 inhibitor-based chemotherapy may enhance treatment efficacy, improve immune response, and reduce immunosuppression-related toxicity in patients with platinum-resistant recurrent ovarian cancer.
Keywords: thymosin α 1, PD1/PD-L1 inhibitors, immunotherapy, T lymphocyte subsets, platinum-resistant ovarian cancer
1Department of Obstetrics and Gynecology, Neijiang Maternal and Child Health Hospital, Neijiang, Sichuan, People’s Republic of China; 2Orthopedic Department, the Second People’s Hospital of Neijiang, Neijiang, Sichuan, People’s Republic of China
Correspondence: Zhendong Li, Orthopedic Department, the Second People’s Hospital of Neijiang, Neijiang, Sichuan, People’s Republic of China, Email 15282193909@163.com
Background: Platinum-resistant recurrent ovarian cancer remains a major therapeutic challenge. Immune checkpoint inhibitors (ICIs) combined with chemotherapy are widely used, but clinical benefits remain limited. Thymosin α 1 (Tα 1), an immunomodulatory peptide, may synergize with ICIs to enhance anti-tumor immunity.
Methods: This retrospective study included 386 patients with PROC, with 193 patients receiving Tα 1 combined with PD-1/PD-L1 inhibitors and chemotherapy (experimental group), and 193 patients receiving PD-1/PD-L1 inhibitors and chemotherapy alone (control group). Baseline clinical characteristics, clinical efficacy, immune parameters, progression-free survival (PFS), and adverse events were compared between the two groups. Kaplan–Meier survival analysis and multivariate Cox proportional hazards regression were used to assess PFS and associated prognostic factors. Continuous and categorical variables were compared using t-test and χ2-test, respectively. Statistical significance was defined as p < 0.05.
Results: Baseline characteristics were comparable between the two groups. The experimental group showed significantly higher objective response rate (43% vs 30.2%; p = 0.008) and disease control rate (87% vs 69.8%; p = 0.000). The median PFS was significantly longer in the experimental group (3.0 vs 1.1 months; HR = 3.22, 95% CI: 2.59– 4.01; p = 0.000). Post-treatment, patients in the experimental group demonstrated significantly elevated levels of IgA, IgG, IgM, CD3+, CD4+, CD4+/CD8+ ratio, and NK cells compared to the control group (all p < 0.01), while CD8 levels remained similar. The incidence of adverse events was lower in the experimental group (50.8% vs 65.8%; χ2 = 8.35, p = 0.004), primarily due to a reduced rate of myelosuppression.
Conclusion: The addition of Tα 1 to PD-1/PD-L1 inhibitor-based chemotherapy may enhance treatment efficacy, improve immune response, and reduce immunosuppression-related toxicity in patients with platinum-resistant recurrent ovarian cancer.
Keywords: thymosin α 1, PD1/PD-L1 inhibitors, immunotherapy, T lymphocyte subsets, platinum-resistant ovarian cancer