脑下垂体相关的免疫不良事件由计划死亡诱导 蛋白-1 抑制剂在临床上不同于缺血炎
Lijuan Yang1, Yao Zhang2, Xiaoyu Chen3
1Department of Endocrinology, The 3rd Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Clinical endocrinology
|May 16, 2024
概括
在中国患者中,PD-1抑制剂的免疫相关不良事件 (irAEs) 主要导致孤立的ACTH缺乏症,而不是典型的低血压炎. 这一发现突显了这个人群中垂体irAEs的特定临床表现.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 内分泌学 在内分泌学.
背景情况:
- 编程细胞死亡蛋白1 (PD-1) 抑制剂在癌症治疗中至关重要.
- 免疫相关的不良事件 (irAEs) 可以影响各种器官,包括垂体腺.
- 了解垂体iRAEs对于管理PD-1抑制剂治疗的患者至关重要.
研究的目的:
- 在中国队列中,以PD-1抑制剂诱导的垂体irAEs的临床特征进行鉴定.
- 将这些特征与以前文献的发现进行比较.
主要方法:
- 追溯分析14名患有由PD-1抑制剂引起的垂体irAEs的患者.
- 在PubMed的文献中搜索相关的英语文章 (1950-2023年).
- 队列和公布数据 (94名患者) 之间的临床特征比较.
主要成果:
- 在队列中,85.71%的人患有孤立的ACTH缺乏症 (IAD);100%的人患有中央上腺皮缺陷.
- 在队列中的MRI上没有观察到下垂体扩大.
- 文献审查显示,82.98%的患者接受了IAD,而78.33%的患者下垂体成像正常.
结论:
- 来自PD-1抑制剂的垂体irAEs主要表现为孤立的ACTH缺乏症.
- 典型的下垂体炎特征,如下垂体扩大和多种激素缺乏,并不常见.
- 这表明甲状腺与PD-1抑制剂的参与有着独特的模式.
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