焦虑或抑郁症诊断与免疫检查点抑制剂结局之间的关联
Heather Derry-Vick1,2, Neil J Shah3, Jaeil Ahn4
1Cancer Prevention Precision Control Institute, Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, New Jersey, USA.
Cancer medicine
|November 2, 2025
概括
预先存在的焦虑诊断与更多的免疫相关不良事件 (irAEs) 有关,但在接受免疫检查点抑制剂 (ICI) 治疗的患者中,整体存活率 (OS) 更好. 抑郁症对ICI结果没有显著影响.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 精神病学是一个精神病学.
背景情况:
- 焦虑和抑郁可以影响免疫功能,但它们对免疫检查点抑制剂 (ICI) 治疗结果的具体影响仍然不清楚.
- 了解这些关联对于优化癌症治疗策略至关重要.
研究的目的:
- 研究在接受抗PD-1或抗PD-L1单一治疗的患者中先前存在的焦虑或抑郁症诊断和结果之间的关系.
- 确定这些心理健康状况是否影响与免疫相关的不良事件 (irAEs),整体存活率 (OS) 和治疗失败的时间 (TTF).
主要方法:
- 对接受抗PD-1或抗PD-L1治疗的患者的多中心回顾性真实世界数据的二次分析.
- 关键变量包括治疗开始时的焦虑/抑郁症诊断,irAEs,OS,TTF以及社会人口统计学/临床因素.
主要成果:
- 与未经诊断的患者相比,患有焦虑症的患者更有可能经历irAEs (OR=1.80) 和改善OS (HR=0.74) 的可能性更高.
- 抑郁症诊断与irAEs,OS或TTF没有显著的关联.
- 在非小细胞肺癌 (NSCLC) 患者中,焦虑呈现出更好的生存状况和更长的TTF的趋势,而irAEs没有显著差异.
结论:
- 预先存在的焦虑症可能会显著影响抗PD-1或抗PD-L1疗法治疗的患者的临床结果.
- 需要进一步的翻译和前性研究来探索心理社会因素与ICI结果之间的联系.
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