与免疫检查点抑制剂相关的3级或4级肝损伤负担
Lucia Parlati1,2, Mehdi Sakka3, Aurelia Retbi4
1Université Paris Cité, Paris, France.
JHEP reports : innovation in hepatology
|December 11, 2023
概括
免疫检查点抑制剂 (ICI) 可以导致癌症患者的肝损伤,观察到9%的严重肝损伤发生率. 像抗PD-L1/抗CTLA-4抗体这样的组合疗法增加了这种风险,但肝衰竭很少见.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
背景情况:
- 免疫检查点抑制剂 (ICI) 越来越多地用于癌症治疗.
- 有关ICI在癌症患者中可能导致肝损伤的可能性存在担忧.
研究的目的:
- 评估ICI治疗的癌症患者严重 (3/4级) 肝损伤和肝衰竭的发生率.
- 为了比较ICI治疗和常规化疗之间的肝损伤风险.
- 确定ICI诱导的肝损伤的风险因素,并评估结果.
主要方法:
- 对952名癌症患者进行了回顾性队列研究,这些患者接受了ICI治疗.
- 与接受常规化疗的患者进行倾向匹配的比较.
- 使用常见术语标准对不良事件 (CTCAE) 的肝损伤的评估v5.5.
- 使用RUCAM方法对肝损伤的因果关系评估.
主要成果:
- 9%的患者患有3/4级肝损伤;没有观察到肝衰竭.
- 严重肝损伤的独立风险因素包括抗PD-L1/抗CTLA-4抗体组合和慢性乙肝.
- 在2%的患者中,直接ICI肝毒性被确定,通常呈现为粒状肝炎或胆管细胞炎症.
- 停用ICI与癌症进展和死亡率有关;重新引入ICI并没有增加复发性肝损伤的风险.
结论:
- 联合抗PD-L1/抗CTLA-4抗体治疗与严重肝损伤的风险增加有关.
- 尽管存在严重损伤的可能性,但肝衰竭仍然不常见,即使在ICI重新引入时也是如此.
- 由ICI引起的肝损伤需要谨慎管理,平衡治疗效益与毒性风险.
更多相关视频
00:06An Oncogenic Hepatocyte-Induced Orthotopic Mouse Model of Hepatocellular Cancer Arising in the Setting of Hepatic Inflammation and Fibrosis
Published on: September 12, 2019
8.9K
12:24A Three-Dimensional Spheroid Model to Investigate the Tumor-Stromal Interaction in Hepatocellular Carcinoma
Published on: September 30, 2021
5.2K
相关概念视频
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
188
Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
188
01:27Tumor Immunotherapy
529
Immunotherapy is a treatment that boosts or manipulates the immune system to fight diseases, including cancer. For instance, by stimulating an immune response through vaccinations against viruses that cause cancers, like hepatitis B virus and human papillomavirus, these diseases can be prevented. Nonetheless, some cancer cells can avoid the immune system due to their rapid mutation and division. The immune response to many cancers involves three phases: elimination, equilibrium, and escape.
529