患有炎症性肠病或暴露于检查点抑制剂的微观结肠炎患者的结肠炎风险:一项丹麦国家队列研究
Emilie Kristine Dahl1,2, Katrine Risager Christensen2,3, Henrik Albæk Jacobsen4
1Department of Digestive Diseases, Transplantation and General Surgery, Rigshospitalet, Denmark.
JCO oncology practice
|October 14, 2025
概括
用免疫检查点抑制剂 (ICI) 治疗的炎症性肠病患者面临更高的肠球炎风险. 然而,克罗恩氏病患者的风险较低,大多数患者可以继续ICI治疗.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 免疫学 免疫学 免疫学
背景情况:
- 免疫检查点抑制剂 (ICI) 是关键的癌症治疗方法.
- 患有性结肠炎 (UC),克罗恩病 (CD) 和显微结肠炎 (MC) 等炎症性肠病 (IBD) 的患者经常被排除在ICI试验之外,因为担心疾病恶化.
- 在IBD患者中,ICI介导肠道结肠炎 (IMC) 的风险需要仔细评估.
研究的目的:
- 评估ICI治疗IBD的癌症患者发展疾病活动或IMC的风险.
- 为了比较患有UC,CD和MC的患者之间的IMC风险.
主要方法:
- 全国范围,丹麦的回顾性队列研究.
- 在2010年至2024年期间,对被诊断患有UC,CD或MC并接受ICI治疗的癌症患者的分析.
- 与没有肠道疾病的对照队列进行比较.
主要成果:
- 在85名IBD患者中,39%患有IMC;72%继续ICI治疗.
- 与UC和MC患者相比,克罗恩病患者的IMC几率比率较低 (OR,0.07;P = .02).
- 与用抗PD-1/抗PD-L1抑制剂治疗的对照组相比,IBD患者的IMC风险明显更高 (HR,4.93;P<.001).
结论:
- 患有IBD的癌症患者通常可以耐受ICI治疗,大多数继续治疗.
- 克罗恩氏病患者的IMC风险似乎比UC和MC患者低.
- 在IBD患者中,应根据与没有肠道疾病的患者相同的标准考虑ICI治疗.
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