治疗后免疫检查点与抑制剂相关的甲状腺功能监测的充分性
Maria A Velez1, Elliot S Kang1, Chester A Thompson1
1Department of Medicine, Division of Hematology and Oncology, University of California, Los Angeles, Los Angeles, CA.
JCO oncology practice
|June 2, 2025
概括
免疫后检查点抑制剂 (ICI) 甲状腺功能障碍很常见,影响11.6%的监测患者. 监测不足可能导致在癌症治疗后对这种内分泌不良事件的认知不足.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
背景情况:
- 免疫检查点抑制剂 (ICI) 是广泛使用的癌症疗法.
- 甲状腺功能障碍是ICI已知的内分泌副作用之一.
- 关于ICI治疗停止后发生的甲状腺功能障碍的数据有限.
研究的目的:
- 调查ICI治疗后甲状腺功能障碍的发生率和识别.
- 为了确定ICI后甲状腺功能障碍是否由于监测不足而未得到充分认可.
主要方法:
- 对3626名接受ICI治疗的患者进行了回顾性分析.
- 在ICI治疗之前,期间和之后评估临床显著的甲状腺功能障碍.
- 治疗后甲状腺实验室监测率的评估.
主要成果:
- 临床治疗的甲状腺功能障碍在ICI治疗期间发生在8.1%,在ICI治疗后发生在4.4%.
- 在没有先前功能障碍的患者中,11.6%的患者在ICI后出现了甲状腺功能障碍.
- 48.6%的患者缺乏ICI后的甲状腺实验室结果;30%的患者在停止治疗前出现异常的TSH功能障碍.
结论:
- 在ICI后的甲状腺功能障碍是常见的,并且可能被忽视.
- 在停止治疗前患有异常TSH的患者和接受治疗长达9个月的患者需要密切监测.
- 加强治疗后监测对于管理ICI诱导的内分泌不良事件至关重要.
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