免疫检查点抑制剂用于患有慢性间歇性肺炎的肺癌患者
Kazutoshi Isobe1, Yasuhiko Nakamura1, Susumu Sakamoto1
1Division of Respiratory Medicine, Toho University School of Medicine, Tokyo, Japan.
ERJ open research
|March 6, 2024
概括
免疫检查点抑制剂 (ICI) 治疗在间歇性肺炎 (IP) 的肺癌中显示出有效性,尽管免疫检查点抑制剂肺炎 (ICIP) 影响30.5%. 经历免疫相关不良事件 (irAEs) 的患者表现出更好的生存结果.
科学领域:
- 在瘤学瘤学.
- 肺部病理学 肺部病理学
- 免疫治疗是一种免疫疗法.
背景情况:
- 间歇性肺炎 (IP) 复杂化了肺癌的治疗.
- 免疫检查点抑制剂肺炎 (ICIP) 是接受免疫检查点抑制剂 (ICI) 的患者经常关注的问题.
研究的目的:
- 评估ICI治疗在患有同时IP的肺癌患者的安全性和有效性.
- 确定ICIP和治疗结果的风险因素和预后指标.
主要方法:
- 多中心回顾性观察研究 (2016年6月 - 2020年12月).
- 招募了200名原发性肺癌和IP接受ICI治疗的患者.
- 分析了ICIP的发生率,肺炎的严重程度,整体存活率 (OS),无进展存活率 (PFS) 和与免疫相关的不良事件 (irAEs).
主要成果:
- ICIP发生在30.5%的患者中;15.5%患有严重的肺炎 (3-5级).
- 组织性肺炎是ICIP最常见的CT模式 (47.5%). 扩散膜损伤 (DAD) 模式与更糟糕的预后有关 (PFS: 115 与 226 天; OS: 334 与 1316 天).
- 大约50%的患者经历了irAEs,与没有irAEs的患者相比,PFS和OS显著改善. 目标响应率为41.3%.
结论:
- ICI治疗对具有IP的肺癌是有效的,但ICIP具有显著的风险.
- 存在irAEs与改善的生存率有关,这表明与治疗疗效的潜在联系.
- 在ICIP中的DAD模式表明预后较差,强调需要仔细监测.
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