Impact of CTLA-4 Inhibitor Combined with Chemotherapy on Immunoglobulin Levels and General Condition in Breast Cancer Patients

Abstract

This study conducted an evaluation of the CTLA-4 inhibitor ipilimumab plus standard chemotherapy on immunoglobulin levels, performance status, and Quality of Life (QoL) in patients with stage I-III Breast Cancer (BC) via a randomized controlled trial. 120 patients with stage I-III BC were randomly allocated to the experimental group (chemotherapy + ipilimumab) and the control group (chemotherapy), and the treatment cycle was 12 weeks. The results revealed that the combination treatment significantly increased the levels of serum IgG, IgA, and IgM (for example, IgG increased by 42.3%, P < 0.01), and the most significant improvement was found in the Luminal subtype. The experimental group had improved Karnofsky Performance Status (KPS) scores, increased body weight, and reduced patient-generated subjective global assessment (PG-SGA) scores, which indicated overall improvement in performance status; the QoL score exhibited a noticeable amelioration, with relief of symptoms (fatigue, pain, etc.) (vs. control group, P < 0.01). Correlation analysis concluded that IgG levels had a positive correlation with QoL (r = 0.56), and nutritional risk scores exhibited a negative correlation (r = -0.64). The incidence of immune-related adverse events (irAEs) was higher in the experimental group (63.3%), but most were grade 1-2 and controllable. In summary, the CTLA-4 inhibitor combined with chemotherapy can improve immune function and QoL in BC patients, with IgG potentially serving as a therapeutic monitoring indicator, especially for patients with the Luminal subtype who may benefit more significantly. In clinical applications, it is necessary to reasonably assess immune-related risks.