免疫疗法长期响应者中的延迟免疫相关不良事件:单中心体验
Masatake Kitano1, Takayuki Honda2, Eri Hikita3
1Department of Respiratory Medicine, Tokyo Metropolitan Bokutoh Hospital, Sumida-ku, Tokyo, Japan.
Asia-Pacific journal of clinical oncology
|April 12, 2024
概括
免疫检查点抑制剂 (ICI) 可以引起与免疫相关的不良事件 (irAEs). 虽然大多数irrAEs发生在一年内,但很少有百分比以后发展,通常有轻微的症状.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 临床药理学 临床药理学
背景情况:
- 免疫检查点抑制剂 (ICI) 在癌症治疗中至关重要,但可以诱导与免疫相关的不良事件 (irAEs).
- 不完全了解irAEs的时间发生和特征,特别是那些在治疗后期出现的.
- 了解irAEs的时间过程对于优化ICI治疗期间的患者管理和安全至关重要.
研究的目的:
- 调查延迟性激发性反应的发生率和特征 (ICI启动后发生>1年).
- 为了比较延迟的IRE与ICI治疗的第一年内发生的IRE.
- 根据其相对于ICI开始的发病时间来分析irAEs的类型和严重程度.
主要方法:
- 从2016年4月至2021年10月期间,对336名实体瘤患者的医疗记录进行了回顾性分析,这些患者接受了ICI (尼沃卢马布,潘布罗利祖马布,杜尔瓦卢马布,阿特佐利祖马布,尼沃卢马布加上伊皮利穆马布) 治疗.
- 患者被分为延迟IRAE (>1年) 组和非延迟IRAE (≤1年) 组.
- 两组之间的irAE类型和严重程度的比较.
主要成果:
- 88名患者 (26.2%) 经历了激发性反应;7名患者 (2.1%) 发展了延迟的激发性反应,而81名患者 (24.1%) 经历了非延迟的激发性反应.
- 延迟性irrAEs的中位发病时间为18.6个月 (范围:13.5-24.3个月).
- 延迟的irrAEs包括皮肤炎,肺炎,炎,关节炎和胃炎,主要是轻微的 (≤G2),其中有一例G3炎.
结论:
- 虽然PD-L1/PD-1抑制剂可以引起各种irrAEs,但大多数是可以控制的.
- 延迟的irrAEs是罕见的,通常存在轻度毒性.
- 这项研究强调了晚期发病的irAEs的可能性,强调了患者监测的持续警.
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