Linkage between Psychological Factors and Response to Immune Checkpoint Inhibitor Therapy: A Preliminary Study

Miri Cohen, Yosi Shamay, Johanna Czamanski-Cohen, Katerina Shulman, Shoshana Keren Rosenberg, Mahmoud Abu-Amna, Ilit Turgeman, Ludmila Merkin Livshits, Revital Birenboim, Monica Dines, Gil Bar-Sela

Research output: Contribution to journalArticlepeer-review


Substantial evidence has accumulated showing that psychological distress affects immune regulation, the response to cancer treatment, and survival. The effect of psychological parameters on the effectiveness of immune checkpoint inhibitor (ICI) treatment has not yet been studied. This preliminary study aimed to (a) examine the associations between psychological factors and responses to ICI treatment and (b) assess the associations between psychological factors and blood measures of sPD-1, sCTLA-4, and cytokines that may alter the effect of ICI treatment. The participants were 62 individuals with advanced cancer, aged 18 years or older, who were candidates for ICI treatment as a new line of treatment. The participants answered questionnaires and provided blood samples and medical data prior to the start of ICI treatment and 3 months after. Perceived health status was positively associated with better responses to ICI treatment. In the subsample of participants with biomarkers, worse health-related quality of life was associated with higher IL-6 and sCTLA-4; emotional distress and sleep difficulties were associated with higher sCTLA-4; and better perceived health was associated with lower IL-6 and TNFα. sPD-1 was not associated with psychological measures. This preliminary study found for the first time that some psychological measures could be linked to responses to cancer treatment, possibly via pro-inflammatory cytokines and sCTLA-4.

Original languageEnglish
Article number2471
Issue number20
StatePublished - 17 Oct 2023

Bibliographical note

Publisher Copyright:
© 2023 by the authors.


  • CTLA-4
  • PD-1
  • cancer
  • cytokines
  • emotional distress
  • health-related quality of life
  • immune checkpoint inhibitor therapy

ASJC Scopus subject areas

  • General Biochemistry, Genetics and Molecular Biology


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