在接受基于抑制剂的免疫检查点治疗的患者中增加了结核病重新激活的风险
Hsing-Wu Chen1,2, Yao-Wen Kuo2,3, Chung-Yu Chen4
1Department of Oncology, National Taiwan University Hospital, Yunlin Branch, Yunlin County, Taiwan, Republic of China.
The oncologist
|January 16, 2024
概括
免疫检查点抑制剂 (ICI) 与氨酸激酶抑制剂 (TKI) 相比,可能会增加肺癌患者肺结核 (TB) 再激活和潜伏结核感染 (LTBI) 的风险. 建议对接受ICI治疗的患者进行结核病早期查.
科学领域:
- 在瘤学瘤学.
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
背景情况:
- 在免疫检查点抑制剂 (ICI) 治疗期间,结核病 (TB) 的报道越来越多.
- 关于ICI作为TB再激活或潜伏结核病感染 (LTBI) 的风险因素的不确定性.
研究的目的:
- 为了确定肺癌患者治疗ICI与氨酸激酶抑制剂 (TKI) 的结核病复激活风险.
- 评估在接受ICI或TKI的患者中LTBI的发生率.
主要方法:
- 使用医院癌症登记册进行回顾性研究,以比较ICI和TKI组之间的结核病发病率.
- 多中心前性研究,使用干扰素释定量 (IGRA) 监测ICI或TKI患者的LTBI发生率.
- 倾向性得分匹配和多变量分析以控制混因素.
主要成果:
- 与TKIs相比,接受ICI的肺癌患者的结核病发病率更高 (每10万人/年2298人vs412人).
- 使用ICI是结核病发展的独立风险因素 (aHR:6.29).
- 在潜在队列中,在接受ICI的患者中,积极的LTBI血清转化发生率显著更高 (18%与0%相比).
结论:
- 与TKI治疗相比,ICI的使用与结核病再激活和LTBI的风险增加有关.
- 在接受ICI治疗的患者中,推对结核病再激活和LTBI进行查,以进行早期检测和管理.
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