| Summary: | Qiqi Liu,1,* Pingping Hu,1,* Guodong Deng,1 Jingxin Zhang,2 Ning Liang,1 Jian Xie,1 Lili Qiao,3 Hui Luo,4 Jiandong Zhang1 1Department of Radiation Oncology, Qianfoshan Hospital Affiliated to Shandong University, Shandong University, Jinan, 2Division of Oncology, Department of Graduate, Weifang Medical College, Weifang, 3Department of Oncology, The Fifth People’s Hospital of Jinan, Jinan, 4Department of Radiation Oncology, Henan Cancer Hospital Affiliated to Zhengzhou University, Zhengzhou University, Zhengzhou, Henan, People’s Republic of China *These authors contributed equally to this work Purpose: Soluble cytotoxic T-lymphocyte antigen 4 (sCTLA-4), one of the isoforms of CTLA-4, was discovered to be critical in downregulating the negative signal of CTLA-4 in T-cell responses. Contrary to the classical immunosuppressive effect of CTLA-4, its immunoregulatory function might be complicated. However, the clinical significance of sCTLA-4 to immune regulation and the variation in cancer therapy have not been elucidated. We postulated that the level of sCTLA-4 might affect the outcome of cancer prognosis.Patients and methods: Serum concentrations of sCTLA-4 before and after therapy in 141 locally advanced and advanced cancer patients were measured and survival analyses was performed. Hazard ratio and 95% confidence interval for overall survival (OS) were calculated. Cutoffs were determined by median across the sCTLA-4 level of entire patients.Results: High expression of sCTLA-4 after therapy indicated significant longer OS and progression-free survival (PFS) (all P<0.01). Among all subgroups, sCTLA-4 levels after therapies were found to be significantly higher than that of 1 day before, which was also negatively correlated with tumor node metastasis stage and lymph node metastasis (all P<0.05). Multivariate analysis revealed that sCTLA-4 level was a strong independent prognostic factor for OS and PFS (all P<0.05).Conclusion: Our data demonstrated the favorable prognostic significance of sCTLA-4 and may lead to the development of new immunotherapy options for cancer patients. Keywords: soluble cytotoxic T-lymphocyte antigen 4, immunotherapy, survival, cancer therapy, cancer prognosis
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