免疫检查点抑制剂和氨酸激酶抑制剂对甲状腺功能的联合作用
Karen Tsai1, Huiyan Ma2, Tom Z Liang3
1Department of Diabetes, Endocrinology and Metabolism, City of Hope Comprehensive Cancer Center, Duarte, California, USA.
Thyroid : official journal of the American Thyroid Association
|December 9, 2023
概括
使用免疫检查点抑制剂 (ICI) 和氨酸激酶抑制剂 (TKI) 的联合癌症治疗经常导致甲状腺功能障碍. 建议密切监测甲状腺功能,因为这些不良事件的迅速发作和高发病率.
科学领域:
- 在瘤学瘤学.
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 免疫检查点抑制剂 (ICI) 和氨酸激酶抑制剂 (TKI) 越来越多地用于结合治疗固体瘤.
- 甲状腺功能障碍是ICI和TKI单独使用的已知副作用.
- 结合ICI+TKI治疗对甲状腺功能的影响在很大程度上仍未被描述.
研究的目的:
- 评估ICI+TKI联合治疗期间甲状腺异常的发生率,临床特征和危险因素.
- 评估ICI+TKI诱导的甲状腺功能障碍与癌症结局之间的关系.
- 确定这种患者群体中甲状腺功能障碍的最佳管理策略.
主要方法:
- 对106名接受ICI+TKI联合治疗的患者进行了回顾性队列研究.
- 在治疗前和治疗期间对甲状腺功能测试 (TSH) 的分析.
- 评估风险因素,包括性别和药物治疗方案.
- 评估无进展生存率和整体生存率.
主要成果:
- 63.2%的患者出现甲状腺功能异常.
- 发病率包括甲状腺功能障碍症 (10.4%),亚临床甲状腺功能障碍症 (39.6%) 和明显的甲状腺功能障碍症 (13.2%).
- 甲状腺功能障碍的发病速度很快,在治疗开始后平均7-8周发生.
结论:
- 结合ICI+TKI治疗与甲状腺功能障碍的高发病率有关.
- 甲状腺功能障碍的发病速度很快,这表明潜在的免疫相关甲状腺炎.
- 建议对接受ICI+TKI治疗的患者进行密切的甲状腺功能监测和多学科内分泌治疗.
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