Hydrogen Gas Boosts Cancer Immunotherapy Success in Lung Cancer Patients
- Authors
- Junji Akagi, Hideo Baba
- Journal
- Oncology Letters
- Year
- 2020
- DOI
- 10.3892/ol.2020.12121
- Study Type
- Human
- Outcome
- Positive
- Peer Reviewed
- Yes
- Country
- Japan
- Health Condition
- Lung Cancer
- Body System
- Immune System
TL;DR
Inhaling hydrogen gas appears to improve the survival of lung cancer patients treated with the immune therapy drug nivolumab by boosting the energy production in immune cells.
Key Finding
Lung cancer patients treated with hydrogen gas combined with nivolumab had significantly longer overall survival compared to those receiving nivolumab alone, with the best outcomes in patients showing increased coenzyme Q10 levels and reduced exhausted T cell markers.
Summary
This study examined whether hydrogen gas combined with nivolumab (an immunotherapy drug) improves outcomes in lung cancer patients. Researchers measured immune cell markers and mitochondrial function (using coenzyme Q10 as a measure) in 42 patients receiving both treatments compared to 14 receiving nivolumab alone. Patients who received hydrogen gas with nivolumab lived longer on average, and those whose immune cells showed specific improvements (lower exhaustion markers and higher mitochondrial function) had the best outcomes.
Practical Takeaway
While this human study suggests hydrogen gas may enhance immunotherapy effectiveness in lung cancer, the small sample size (42 patients receiving both treatments) and lack of reported study duration limit how much weight can be placed on these findings. This early evidence indicates hydrogen gas warrants further investigation as a potential complement to cancer immunotherapy, but more rigorous, larger studies are needed before any clinical recommendations can be made.
Abstract
As previously reported, hydrogen gas improves the prognosis of patients with cancer by restoring exhausted CD8+ T cells into active CD8+ T cells, possibly by activating mitochondria. As mitochondrial activators exhibit synergistic effects with nivolumab, the current study investigated whether hydrogen gas also affects the clinical outcomes of nivolumab. A total of 42 of 56 patients with lung cancer treated with nivolumab received hydrogen gas. Exhausted markers (PD-1 and Tim-3) on cell populations in the CD8+ T cell differentiation pathway were analyzed using flow cytometry. The concentration of coenzyme Q10 (CoQ10) was measured as a marker of mitochondrial function. The 42 patients treated with hydrogen gas and nivolumab (HGN) indicated a significantly longer overall survival (OS) compared with those treated with nivolumab only (n=14). In multivariate analysis, PD-1+Tim-3+terminal CD8+ T cells (PDT+) were an independent poor prognostic factor in OS, and CoQ10 showed a tendency to be associated with improved OS. The change in the rate of PDT+ and CoQ10 after vs. before HGN (PDT+ ratio and CoQ10 ratio, respectively) revealed that patients with low PDT+ ratio (1.175) had significantly longer OS compared with those with high PDT+ ratio and low CoQ10 ratio. Furthermore, PDT+, with a significant reverse correlation with CoQ10, was significantly lower in patients with high CoQ10 and/or CoQ10 ratio than in those low CoQ10 and/or CoQ10. Hydrogen gas has been suggested to enhance the clinical efficacy of nivolumab by increasing CoQ10 (mitochondria) to reduce PDT+, with PDT+ and CoQ10 as reliable negative and positive biomarkers of nivolumab, respectively.