抗PD-1疗法诱导的甲状腺功能障碍与晚期癌瘤患者的无进展生存率更好有关
Yiran Lu1, Qingchen Li2, Lusi Xu3
1Department of Endocrinology, Qilu Hospital, Shandong University, Ji-Nan, China.
Journal of cancer research and clinical oncology
|September 15, 2023
概括
甲状腺功能障碍是癌症患者抗编程细胞死亡1 (抗PD-1) 治疗的常见副作用. 在治疗期间发展这种疾病与改善无进展生存率有关.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 内分泌学 在内分泌学.
背景情况:
- 反编程细胞死亡1 (抗PD-1) 疗法是癌症治疗的重大进展.
- 甲状腺功能障碍是与抗PD-1疗法相关的已知的免疫相关不良事件.
- 了解这种不良事件的特征和预后影响至关重要.
研究的目的:
- 调查晚期恶性瘤患者的抗编程细胞死亡1 (抗PD-1) 疗法诱导的甲状腺功能障碍的发生率和临床特征.
- 评估抗PD-1诱导的甲状腺功能障碍与患者预后之间的相关性,特别是无进展生存期 (PFS).
主要方法:
- 一组接受抗PD-1治疗的晚期癌症患者被追溯分析.
- 在2020年8月至2022年3月期间,在基线和治疗后开始监测甲状腺功能.
- 包括73名患者,使用Kaplan-Meier和Cox回归模型分析生存结果.
主要成果:
- 甲状腺功能障碍发生在26.03%的患者身上,主要的甲状腺功能低下和甲状腺毒性是最常见的表现.
- 抗PD-1诱导的甲状腺功能障碍的开始发生在63天的中位数,甲状腺毒性出现的时间早于甲状腺功能低下.
- 患有甲状腺功能障碍的患者表现出明显更好的PFS (227天) 与没有 (164天) 的患者相比 (p=0.026).
- 抗PD-1诱导的甲状腺功能障碍被确定为更好的PFS的独立预测因素 (HR=0.339,p=0.021).
结论:
- 甲状腺功能障碍是接受抗PD-1治疗的晚期癌症患者常见的免疫相关不良事件.
- 在抗PD-1治疗期间甲状腺功能障碍的发展与显著改善的预后 (更好的PFS) 有关.
- 对接受抗PD-1治疗的患者来说,监测甲状腺功能很重要,因为其功能障碍可能表明治疗反应良好.
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