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暴露于免疫检查点抑制剂的患者的慢性胃肠道免疫相关不良事件
Marine Jeay1, Franck Carbonnel1, Caroline Robert2
1Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Université Paris-Saclay, Le Kremlin Bicêtre, 78 Rue du Général Leclerc, Le Kremlin-Bicêtre 94270, France.
慢性胃肠道免疫相关不良事件 (GI IrAEs) 可能在免疫检查点抑制剂 (ICI) 治疗后持续很长时间. 这些情况可能涉及炎症,或狭窄,需要持续管理.
科学领域:
- 胃肠病学 胃肠病学
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
背景情况:
- 免疫检查点抑制剂 (ICI) 与急性胃肠道免疫相关不良事件 (GI IrAEs) 有关.
- 这些事件的长期后果,特别是慢性胃肠道IRAE,不太了解.
研究的目的:
- 描述慢性胃肠道IRAE的发病率,临床表现和管理.
- 描述ICI治疗后经历持续性肠道炎症的患者的长期结果.
主要方法:
- 在ICI后至少持续6个月的胃肠道炎症患者的回顾性分析.
- 包括标准需要内镜和/或组织学炎症证据.
- 收集的数据包括症状,内镜检测结果,组织学,治疗和随访结果.
主要成果:
- 在178名患者中,有14名 (8%) 符合慢性胃肠道IRAE的标准.
- 水性腹是最常见的症状 (54%);结肠干扰 (77%) 和炎症性病变 (77%) 是常见的.
- 组织学显示了淋巴细胞透和基底血细胞;15%的患者患有抽,8%的患者患有狭窄.
- 使用药物治疗 (69%),包括vedolizumab和手术 (15%);内镜病变在4/6名患者中持续了一年.
结论:
- 慢性胃肠道IRAE在ICI治疗后代表了一个独特的临床实体.
- 这些情况可以表现为显著的胃肠道病理,需要长期的管理策略.
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