转移性结直肠癌中的免疫疗法诱导的大肠炎:系统性审查和元分析
Sakditad Saowapa1, Natchaya Polpichai2, Pharit Siladech3
1Department of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.
概括
转移性结肠直肠癌 (mCRC) 的免疫疗法可能导致结肠炎. 抗细胞毒性T-淋巴细胞相关分子-4 (抗CTLA-4) 和组合疗法增加结肠炎的风险,特别是在免疫疗法无知的患者中.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 免疫学 免疫学 免疫学
背景情况:
- 结肠直肠癌 (CRC) 具有显著的死亡风险,需要有效的治疗.
- 先进的CRC管理包括化疗,向治疗,免疫治疗,放射治疗和手术.
- 免疫疗法虽然对抗癌症有力,但可以诱导诸如结肠炎之类的有毒副作用.
研究的目的:
- 评估在接受免疫治疗的转移性结肠直肠癌 (mCRC) 患者中结肠炎的发生率.
- 为了比较不同免疫疗法方案的结肠炎发病率.
- 确定患有免疫疗法诱导大肠炎风险较高的患者子组.
主要方法:
- 在谷歌学者和PubMed数据库的系统文献搜索 (开始至2023年11月).
- 包括九项相关研究进行分析.
- 亚组分析以基于治疗类型和患者病史的结肠炎发病率进行比较.
主要成果:
- 与抗细胞毒性T淋巴细胞相关分子-4 (抗CTLA-4) 和组合疗法相比,PD-1/PDL-1单疗法观察到更高的结肠炎发病率.
- 与之前接受免疫治疗的mCRC患者相比,免疫治疗的mCRC患者的结肠炎发病率增加.
- 特定的组合疗法 (例如,尼沃卢马布加上伊皮利穆马布) 与大肠炎发病率的增加有关.
结论:
- 抗CTLA-4和组合免疫疗法与mCRC患者的结肠炎风险增加有关.
- 免疫疗法原始状态是高结肠炎发病率的风险因素.
- 对于接受免疫治疗的患者,特别是新接收者,警监测和主动管理至关重要.
相关概念视频
Tumor Immunotherapy
511
Immunotherapy is a treatment that boosts or manipulates the immune system to fight diseases, including cancer. For instance, by stimulating an immune response through vaccinations against viruses that cause cancers, like hepatitis B virus and human papillomavirus, these diseases can be prevented. Nonetheless, some cancer cells can avoid the immune system due to their rapid mutation and division. The immune response to many cancers involves three phases: elimination, equilibrium, and escape.
511
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
156
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
156
Drugs for Treatment of Ulcerative Colitis in IBD
135
Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
135


