用免疫检查点抑制剂治疗的大脑瘤伪进展的临床和放射性特征
Maria José Ibáñez-Juliá1, Luis Bataller2,3, Francisco Javier Cabello-Murgui4
1Neuroscience Department Ascires Biomedical Group, Valencia, Spain.
Journal of neuro-oncology
|May 27, 2025
概括
伪进展 (PsP) 是免疫检查点抑制剂 (ICI) 在脑瘤患者中常见的与免疫相关的不良影响. 症状病例不应自动排除,较高的瘤负担和PD-L1表达可能与PsP有关.
科学领域:
- 神经瘤学神经瘤学
- 免疫治疗是一种免疫疗法.
- 放射学 放射学是一门学科.
背景情况:
- 免疫检查点抑制剂 (ICI) 正在彻底改变癌症治疗.
- 免疫相关的不良反应 (irAEs),包括伪进展 (PsP),是新出现的并发症.
- 用ICI治疗的大脑瘤中的PsP需要进一步描述.
研究的目的:
- 评估接受ICI的大脑瘤成年患者伪进展 (PsP) 的特征.
- 在这个患者群体中,将PsP的特征与非PsP组进行比较.
- 评估临床症状对PsP诊断和管理的影响.
主要方法:
- 对102名脑瘤成年患者进行了回顾性分析,这些患者接受了ICI治疗 (2015-2023).
- 纳入标准:治疗前和治疗后6个月内MRI扫描.
- PsP被定义为放射性恶化,其次是稳定/改善,没有治疗变化;比较PsP和非PsP组之间的人口统计,临床和放射性数据.
主要成果:
- 10%的患者 (10/102) 发生了PsP.
- 40%的PsP病例 (4/10) 有症状,对皮质类固醇反应良好.
- 与非PsP组相比,PsP组显示出更高的基线瘤负担 (p < 1.29x10−13) 和PD-L1表达 (p < 0.001).
结论:
- 伪进展是ICI在脑瘤中的常见并发症.
- 症状呈现不应排除PsP的诊断,挑战目前的标准.
- 较高的瘤负担和PD-L1表达可能与PsP有关,需要进一步调查.
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