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免疫检查点抑制剂的癌症类型特异性不良事件:系统性审查和元分析
Xuhui Tong1,2, Rong Tang3,4, Jin Xu1,2
1Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.
Heliyon
|January 27, 2025
概括
免疫检查点抑制剂 (ICI) 显示癌症特异性不良事件. 黑色素瘤患者在使用抗PD-1时经常感到疲劳,而前列腺癌患者在使用抗CTLA-4时,腹的发病率很高. 了解这些模式对于安全的ICI治疗至关重要.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 临床试验 临床试验
背景情况:
- 免疫检查点抑制剂 (ICI) 对不同癌症类型的不良事件 (AEs) 的分布在很大程度上仍然没有特征.
- 之前的研究还没有全面分析与ICI单疗相关的癌症特异性AE概况.
研究的目的:
- 系统地调查和总结与ICI单疗相关的各级和严重治疗相关不良事件 (TRAE) 在各种癌症类型中的分布.
- 确定特定的TRAE与不同癌症诊断之间的特定联系.
主要方法:
- 一个系统的审查和随机对照试验 (RCT) 的元分析,涉及ICI单疗在超过100个人的患者队列.
- 数据提取集中在所有等级的TRAE和严重的TRAE (CTCAE等级≥3).
- 这项研究已注册在PROSPERO (CRD42023387934) 上.
主要成果:
- 对75项试验的分析揭示了与癌症类型相关的明显的TRAE模式.
- 接受抗PD-1治疗的黑色素瘤患者表现出疲劳的最高发病率 (31.1%).
- 霍奇金淋巴瘤患者的严重肺炎 (4.1%) 和呼吸系统疾病的发病率最高.
- 接受抗PD-L1治疗的细胞癌 (RCC) 患者经历了增加的 (19.0%) 和严重的肌肉骨疾病 (6.2%).
- 接受抗CTLA-4治疗的前列腺癌患者表现出所有级别 (41.9%) 和严重腹 (14.8%) 的最高频率.
结论:
- 这项研究提供了首次全面概述ICI治疗后不同癌症类型的TRAE分布.
- 这些发现强调了识别和管理癌症特异性TRAE至关重要,以优化ICI治疗疗效和患者安全.
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