接受免疫检查点抑制剂的晚期癌症的固体器官移植接受者的结果:系统性审查和个人参与者数据元分析
Nida Saleem1,2,3, Jiayue Wang2,4, Angela Rejuso2,4
1Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
JAMA oncology
|June 23, 2025
概括
免疫检查点抑制剂 (ICI) 在实体器官移植接受者 (SOTR) 中显示出不同的癌症反应. 同时使用mTOR抑制剂和类固醇可能会降低急性异构移植排斥风险.
科学领域:
- 在瘤学瘤学.
- 移植免疫学 移植免疫学
- 免疫治疗是一种免疫疗法.
背景情况:
- 免疫检查点抑制剂 (ICI) 已经改变了先进的癌症治疗,改善了生存率.
- 关于ICI在固体器官移植接受者 (SOTR) 的有效性和安全性的数据有限.
研究的目的:
- 为了评估癌症特异性和患者存活率的SOTRs与ICIs治疗的晚期癌症.
- 在这个人群中确定影响患者和移植结果的因素.
主要方法:
- 一个系统的审查和对涉及使用ICI治疗的SOTR研究的元分析.
- 包括病例报告,观察性研究和临床试验.
- 使用随机效应模型和Cox比例危险回归的个人参与者数据合成.
主要成果:
- 分析了128项研究,其中343个是用ICI治疗的SOTR.
- 癌症反应因类型而异;皮肤状细胞癌 (cSCC) 显示出更高的反应率.
- 在1年内,急性排斥发生在36.2%,移植损失发生在18.4%.
- 与cSCC相比,黑色素瘤和其他固体器官癌症与较高的癌症相关死亡率有关.
- 维护类固醇和mTOR抑制剂与较低的排斥风险有关.
结论:
- 在接受ICI的SOTR患者中,癌症结局不同,cSCC患者表现出更好的反应.
- 同时使用mTOR抑制剂和类固醇可以减轻ICI治疗期间急性全移植排斥风险.
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