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探索与内分泌相关的免疫相关不良事件的风险因素:从元分析和孟德尔随机化中的见解

Liuliu Quan^1,2, Jinsong Liu^1,2, Yuxin Wang³

¹Department of Medical Oncology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Human vaccines & immunotherapeutics

|October 8, 2024

概括

内分泌相关的免疫相关不良事件 (EirAEs) 与特定的风险因素有关,如提升的TSH和甲状腺抗体. 在免疫治疗期间经历EirAEs与改善患者生存结果相关.

科学领域:

免疫学免疫学免疫学
内分泌学在内分泌学.
在瘤学瘤学.

背景情况:

免疫检查点抑制剂 (ICI) 已经彻底改变了癌症治疗.
内分泌相关的免疫相关不良事件 (EirAEs) 是ICI的常见副作用.
了解EirAEs的风险因素和预后影响对于优化癌症治疗至关重要.

研究的目的:

识别与EirAEs发展相关的风险因素.
调查遗传因素和EirAEs之间的潜在因果关系.
确定EirAEs是否会影响接受免疫治疗的癌症患者的预后.

主要方法:

对现有研究进行元分析,以确定EirAEs的风险因素.
门德尔的随机化 (MR) 分析,以探索遗传因果关系.
生存分析,以评估EirAEs对无进展生存 (PFS) 和整体生存 (OS) 的影响.

主要成果:

EirAEs的主要风险因素包括基线TSH升高,TgAb和TPOAb阳性,甲状腺病史,BMI增加以及组合/双ICI治疗.
核磁共振分析支持极端BMI,甲状腺功能低下症和irAEs之间的因果关系.
患有EirAEs的癌症患者表现出显著延长的PFS和OS.

结论:

几种因素使患者容易接受EirAEs,为风险分层提供了目标.
遗传倾向可能在EirAE发育中起作用.
在接受免疫治疗的癌症患者中,EirAEs与更好的预后有关,这表明潜在的免疫媒介抗瘤作用.

关键词:

内分泌相关的免疫不良事件孟德尔的分析是孟德尔的分析.免疫检查点抑制剂免疫检查点抑制剂这是一个元分析.风险因素的风险因素是什么

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