癌症类型和组织学影响皮肤免疫疗法毒性:一个多机构队列研究
Guihong Wan1,2, Sara Khattab1, Bonnie W Leung1,3,4
1Department of Dermatology, Massachusetts General Hospital, Boston, MA.
The British journal of dermatology
|February 17, 2024
概括
接受免疫检查点抑制剂 (ICI) 治疗的皮肤恶性瘤患者面临皮肤免疫相关不良事件 (cirAEs) 的更高风险. 这种增加的风险与改善的生存结果有关,强调需要更密切的监测.
科学领域:
- 在瘤学瘤学.
- 皮肤病学 皮肤病学
- 免疫治疗是一种免疫疗法.
背景情况:
- 皮肤免疫相关不良事件 (cirAEs) 是与免疫检查点抑制剂 (ICI) 治疗相关的常见毒性.
- 识别患有cirAEs风险较高的患者可以改善治疗结果和生活质量.
研究的目的:
- 检查癌症类型和组织学如何影响接受ICI治疗的患者中cirAEs的发展.
- 研究cirAEs对ICI治疗患者的生存结果的影响.
主要方法:
- 在2011年至2020年期间接受ICI治疗的3668名患者的回顾性队列研究.
- 使用多变量Cox比例危险模型,根据癌症类型和组织学评估基于癌症类型和组织学评估cirAEs的风险,并对共变量进行调整.
- 时间变化的考克斯模型分析了cirAE发展对死亡率的影响.
主要成果:
- 皮肤状细胞癌 (cSCC) 和黑色素瘤显示出明显更高的cirAEs风险 (HR分别为3.57和2.09).
- 其他癌症与增加的cirAE风险包括头部和部腺癌,以及生殖尿路过渡细胞癌和腺癌.
- 发育cirAEs与改善黑色素瘤 (HR 0.37) 和cSCC (HR 0.51) 的存活率有关.
结论:
- 用ICI疗法治疗的皮肤恶性瘤患者经历了最高的CiraEs率和相关的生存益处.
- 这项研究提高了对cirAEs患者风险的理解,为瘤学家和皮肤病学家提供了有针对性的监测和咨询.
- 研究的局限性包括其回顾性设计和单个地理位置的队列.
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