免疫療法の処方パターンと,頭頸部がん患者の免疫関連の有害事象
Andrew M Peterson1,2, Dustin Stwalley3, Dorina Kallogjeri2,4
1Robert Ebert and Greg Stubblefield Head and Neck Tumor Center at Siteman Cancer Center, Washington University School of Medicine, St Louis, Missouri.
JAMA otolaryngology-- head & neck surgery
|February 19, 2026
まとめ
65歳未満の頭頸部がん (HNC) 患者における免疫療法の使用は,承認以来,ペムブロリズマブが市場を支配していることから,わずかに増加しています. 免疫関連の有害事象 (irAEs) は,併発症に関連して一般的であり,重度のirAEsはまれでした.
科学分野:
- 腫瘍学 腫瘍学
- 薬理学 薬理学とは
- クリニック・リサーチ 臨床研究
背景:
- 免疫療法は,再発性/転移性頭頸部がん (HNC) の承認された第一線治療である.
- HNC患者における処方パターンと免疫関連の有害事象 (irAEs) は依然として報告不足である.
- 免疫療法を受けているHNC患者におけるIREsの評価は,臨床管理において極めて重要です.
研究 の 目的:
- HNC患者における免疫療法の処方傾向を評価する.
- この集団におけるirAEsに関連した発生率とリスク要因を決定する.
- 異なる免疫療法剤の市場シェアを分析する.
主な方法:
- MarketScan商用およびメディケイドのデータベース (2016-2022) を使用した遡及的なコホート研究.
- HNC (ICD-10-CMコード) の患者を含む.65歳以上を除く.
- 免疫療法の処方率,iraeの発生率,およびiraeの危険因子の分析.
主要な成果:
- 47,365人のHNC患者の4.8%が免疫療法を受け,処方率は2.3% (2017年) から2.8% (2022年) にわずかに増加した.
- ペムブロリズマブは市場を支配し,2022年までに87%のシェアを獲得した.
- 90日間の全体的なIRAE率は41.2%で,重度のIRAE率は2.7%でした. 甲状腺機能低下症と肝疾患は,irAEsと関連していました.
結論:
- ペムブロリズマブはHNCの主要な免疫療法ですが,全体的な免疫療法の使用は65歳未満の患者で最小の成長を示しています.
- irAEsはHNC患者で頻繁に見られ,甲状腺機能低下症や肝臓疾患などの特定の併発症によりリスクが高まります.
- 重度のIrAEsはまれであり,全体的な併発症負担と関連しています.
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