Anticancer research · 2026
TTF-1 Expression and Efficacy of Platinum and Pemetrexed Plus Pembrolizumab in Advanced Lung Adenocarcinoma.
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Tamura Yosuke, Kawabata Shigeru, Yamaguchi Ryutaro, Asai Yuki, Ishikawa Shoichi, Takezaki Kazuhiro, Kawaguchi Hideaki, Yura Akira, Shimazu Yasuyuki, Arai Masahiro, Mitsuya Sho, Funamoto Tomoya, Tsuji Hiroyuki, Matsunaga Ninso, Tsuruoka Kenjiro, Nakamura Takahiko, Ikeda Soichiro, Fujisaka Yasuhito
Аннотация
BACKGROUND/AIM: Thyroid transcription factor-1 (TTF-1) negativity is a poor prognostic factor for patients with lung adenocarcinoma. Platinum and pemetrexed have inferior therapeutic efficacy compared to other chemotherapy regimens in TTF-1-negative lung adenocarcinomas. However, the association between TTF-1 expression and efficacy of chemotherapy plus immune checkpoint inhibitors remains unclear. The aim of the study was to evaluate whether tumor expression of TTF-1 influence the efficacy of platinum and pemetrexed plus pembrolizumab in patients with advanced adenocarcinoma.
PATIENTS AND METHODS: This single-center retrospective study comprised patients with advanced lung adenocarcinoma treated with platinum and pemetrexed plus pembrolizumab and histologically evaluated for TTF-1 expression between January 2019 and June 2025. TTF-1 was detected in tumor tissue samples obtained by surgery, bronchoscopy, or computer tomography-guided biopsy using 8G7G3/1 antibody. We collected clinical medical records including TTF-1 expression and evaluated the relationship between TTF-1 expression and overall response rate, progression-free survival (PFS), and overall survival (OS). The Cox proportional hazards model was used to determine the association between patient background and survival outcomes.
RESULTS: Of the 54 patients, 29 (53.7%) were TTF-1 positive. PFS (median, 12.6 vs. 13.1 months, p=0.92) and OS (median, 33.4 vs. 41.1 months, p=0.92) did not significantly differ between the TTF-1-positive and TTF-1-negative patients. Multivariate analysis revealed that performance status and primary tumor location were significantly associated with shorter OS, whereas TTF-1 negativity was not significantly associated with shorter OS.
CONCLUSION: Platinum and pemetrexed combined with pembrolizumab remains an effective first-line treatment option for lung adenocarcinoma, regardless of TTF-1 expression.
PATIENTS AND METHODS: This single-center retrospective study comprised patients with advanced lung adenocarcinoma treated with platinum and pemetrexed plus pembrolizumab and histologically evaluated for TTF-1 expression between January 2019 and June 2025. TTF-1 was detected in tumor tissue samples obtained by surgery, bronchoscopy, or computer tomography-guided biopsy using 8G7G3/1 antibody. We collected clinical medical records including TTF-1 expression and evaluated the relationship between TTF-1 expression and overall response rate, progression-free survival (PFS), and overall survival (OS). The Cox proportional hazards model was used to determine the association between patient background and survival outcomes.
RESULTS: Of the 54 patients, 29 (53.7%) were TTF-1 positive. PFS (median, 12.6 vs. 13.1 months, p=0.92) and OS (median, 33.4 vs. 41.1 months, p=0.92) did not significantly differ between the TTF-1-positive and TTF-1-negative patients. Multivariate analysis revealed that performance status and primary tumor location were significantly associated with shorter OS, whereas TTF-1 negativity was not significantly associated with shorter OS.
CONCLUSION: Platinum and pemetrexed combined with pembrolizumab remains an effective first-line treatment option for lung adenocarcinoma, regardless of TTF-1 expression.