与免疫检查点抑制剂相关的多个或单个内分泌异常
Fumika Kamitani1, Yuichi Nishioka2, Hiroki Nakajima1
1Department of Diabetes and Endocrinology, Nara Medical University, 840, Shijo-cho, Kashihara, Nara 634-8522, Japan.
The Journal of clinical endocrinology and metabolism
|June 12, 2025
概括
接受免疫检查点抑制剂 (ICI) 的患者出现内分泌异常,特别是多种异常,显示整体存活率有所改善. 这表明ICI诱导的内分泌问题与更好的患者结果之间存在潜在的联系.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
背景情况:
- 免疫检查点抑制剂 (ICI) 可以导致各种内分泌异常.
- 这些内分泌功能障碍对患者存活率的潜在机制和影响尚未完全理解.
- 在接受ICI治疗的患者中,研究内分泌异常与整体存活率 (OS) 之间的关系至关重要.
研究的目的:
- 研究单个和多个内分泌异常对接受免疫检查点抑制剂 (ICI) 治疗的患者的整体生存期 (OS) 的影响.
- 在接受ICI的患者中识别与内分泌异常相关的风险因素.
主要方法:
- 在2014年至2022年期间使用DeSC日本行政索赔数据库对12978名ICI治疗的患者进行了回顾性分析.
- 内分泌异常是基于激素替代疗法 (勒沃西,皮,胰岛素) 和特定诊断,如甲状腺功能低下后甲状腺炎和1型糖尿病.
- 用回归分析来评估内分泌异常的风险因素及其对生存系统的影响,并根据ICI治疗变量进行调整.
主要成果:
- 在12.0%和1.4%的患者中分别检测到单个和多个内分泌异常.
- 甲状腺功能低下症与上腺功能不足相结合是最常见的组合 (1.3%).
- 患有单个或多个内分泌异常的患者与没有 (P < .01) 的患者相比,显著改善了生存状况 (OS).
- 多变量分析显示,内分泌异常患者的死亡率较低 (多重患者的aHR为0.39,单一患者的aHR为0.65).
- 与单个异常患者相比,多个内分泌异常患者的死亡率明显较低 (aHR为0.56).
结论:
- 在接受ICI治疗的患者中,内分泌异常的发展,特别是多重异常,与改善整体存活率有关.
- 这一发现表明,与ICI诱导的内分泌功能障碍相关的潜在生存益处.
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