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用于治疗免疫检查点抑制剂治疗的患者的类固醇耐药免疫相关不良事件的二线疗法
Theresa Ruf1, Rafaela Kramer2, Andrea Forschner3
1Department of Dermatology and Allergology, University Hospital, LMU Munich, Munich, Germany; SERIO registry.
概括
第二线疗法有效地管理来自免疫检查点抑制剂 (ICI) 的类固醇耐药或类固醇依赖的免疫相关不良事件 (irAEs),而不会对瘤反应产生负面影响. 因弗利西马布可能会为IREs提供更快的症状改善.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 免疫检查点抑制剂 (ICI) 可以在约10%的患者中引起与免疫相关的不良事件 (irAEs).
- 类固醇耐药 (sr) 和类固醇依赖性 (sd) 的irAEs需要除了标准的皮质类固醇治疗之外的替代治疗.
- 关于sr-/sd-irAEs的二线免疫抑制剂及其对瘤控制的影响的基于证据的数据有限.
研究的目的:
- 分析二线免疫抑制剂在管理类固醇耐药性和类固醇依赖性免疫相关不良事件 (irAEs) 的有效性.
- 评估这些二线治疗对免疫检查点抑制剂 (ICI) 治疗的患者瘤反应的影响.
主要方法:
- 利用了来自国际基于网络的副作用登记册免疫瘤学 (SERIO) 的数据.
- 查询了用二线疗法治疗的IRE病例的注册表.
- 分析了217名患者,他们接受了249种不同的二线疗法来治疗irAEs.
主要成果:
- 第二线疗法,包括TNF-α抗体 (46.5%),IVIG (19.1%) 和mycophenolate mofetil (15.9%),在16.3%的irAE病例中使用.
- 大多数sr-/sd-irAEs在二线治疗后得到缓解 (74.3%) 或改善 (13.1%).
- 与mycophenolate mofetil或IVIG相比,infliximab显示出早期症状改善的潜力.
- 接受二线治疗sd-/sr-irAEs的患者的瘤反应与仅使用类固醇治疗的患者相似.
结论:
- 多种二线疗法在治疗类固醇耐药和类固醇依赖的irAEs方面表现出有效性.
- 这些治疗似乎不会影响抗瘤反应.
- 因弗利西马布可能会更快地缓解症状,但需要进行前性比较研究.
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