癌症患者免疫检查点抑制剂相关的血栓栓塞事件:贝叶斯网络元分析
Jinhe Lin1, Wenxing Li1, Xin Zhang1
1Department of Oncology Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China.
Thrombosis research
|December 25, 2024
概括
免疫检查点抑制剂 (ICI) 显示出血栓栓塞事件 (TEE) 的各种风险. 尼沃卢马布表现出静脉血栓塞栓症 (VTE) 的风险最低,而伊皮利马布表现出静脉血栓塞栓症和肺栓塞 (PE) 的风险最高.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 心血管研究研究心血管研究
背景情况:
- 免疫检查点抑制剂 (ICI) 已经改变了癌症治疗.
- ICI与血栓栓塞事件 (TEE) 之间的关联需要澄清.
研究的目的:
- 进行网络元分析 (NMA),评估各种ICI治疗方案的癌症患者的TEE发病率.
- 在不同治疗方法中比较动脉血栓栓塞 (ATE),深静脉血栓塞 (DVT),心肌梗塞 (MI),脑血管事故 (CVAs) 和肺栓塞 (PE) 的风险.
主要方法:
- 从2021年1月到2023年12月的随机临床试验 (RCT) 的系统搜索.
- 国家药物管理局比较单一ICI,双重ICI,常规疗法和组合疗法.
- 根据癌症类型进行子组分析.
主要成果:
- 分析了534736名患者的83个RCT.
- 与传统治疗的双重ICI相比,尼沃卢马布和双重ICI显示出较低的静脉血栓栓塞 (VTE) 风险.
- 伊皮利穆马布比尼沃卢马布的肺栓塞 (PE) 风险更高; 杜尔瓦卢马布与更高的ATE,MI和CVA有关; 伊皮利穆马布与更高的VTE和PE有关; 潘布罗利祖马布与更高的DVT有关.
结论:
- ICI疗法在TEE风险方面存在显著,临床相关的差异.
- 尼沃卢马布在VTE方面具有有利的安全性,而伊皮利马布则具有最高的VTE和PE风险.
- 定制的风险管理策略对于缓解具有不同ICI制度的TEE至关重要.
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