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免疫检查点抑制剂和与癌症相关的认知衰退:积极化疗患者的倾向性得分匹配分析
Guangmin Jian1, Jiling Zeng2, Jun Lu3
1Clinical Laboratory, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Frontiers in immunology
|March 24, 2025
概括
与免疫检查点抑制剂 (ICI) 结合化疗可能会恶化与癌症相关的认知衰退 (CRCD),而不是单独使用化疗. 需要进一步的研究和全面的评估来证实这些关于认知功能的发现.
科学领域:
- 在瘤学瘤学.
- 神经科学是一个神经科学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 癌症治疗,包括化疗和免疫检查点抑制剂 (ICI),可能会影响认知功能.
- 与癌症相关的认知衰退 (CRCD) 是接受癌症治疗的患者的一个重大问题.
- 了解治疗方案对认知的不同影响对于患者护理至关重要.
研究的目的:
- 为了比较接受ICI和单独化疗化疗的患者的1年认知轨迹.
- 用经过验证的措施评估主观和客观认知功能的变化.
- 为了确定组合疗法是否会加剧与癌症相关的认知衰退.
主要方法:
- 从三个学术医院招募患者的前景.
- 一年后的跟进,包括四次评估会议.
- 通过感知认知障碍 (PCI) 测量主观CRCD,通过蒙特利尔认知评估 (MoCA) 测量客观CRCD.
- 倾向性得分匹配 (PSM) 用于均衡的组比较.
- 用于纵向数据分析的线性混合模型.
主要成果:
- 平均PCI和MoCA得分在12个月后在两组中达到临床重要差异最小值 (MCID).
- 与单独化疗相比,化疗加ICI组在12个月后显示出显著较低的MoCA得分变化,并在6,9和12个月后显示出较低的PCI得分变化.
- 在化疗加ICI组中,有意义的损伤事件的一年风险显着更高.
- 化疗组和ICI组的亚组分析显示,基于免疫相关不良事件 (irAEs) 的无事件生存率存在差异.
结论:
- 与ICI结合化疗可能会加剧与单独化疗相比,与癌症相关的认知衰退.
- 目前的发现受到查工具和自我报告措施的使用限制.
- 未来的研究应该采用全面的神经心理评估,以充分阐明ICI对认知功能的影响.
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