癌症免疫疗法组合中不良事件的后果 - - 一个全面的现实世界分析
Siv Gyda Aanes1,2, Carsten Nieder1,2, David Westfall Bates3,4,5,6
1Department of Oncology and Palliative Medicine, Nordland Hospital Trust, Bodø, Norway.
免疫检查点抑制剂 (ICI) 组合会导致频繁的免疫相关不良事件 (irAEs). 新的分类系统更好地捕捉irAE的后果和长期影响,指导改善患者管理.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 免疫检查点抑制剂 (ICI) 在全身癌症治疗中至关重要.
- 与免疫相关的不良事件 (irAEs) 是与ICI相关的显著毒性.
- 了解ICI组合中的IRE对于患者安全和治疗疗效至关重要.
研究的目的:
- 调查接受ICI组合的患者中irrAEs的发生率,严重程度和后果.
- 为了比较不同的不良事件分类系统,以捕获irAEs的能力.
- 为了确定与更高的irAE发病率相关的风险因素.
主要方法:
- 对接受ICI组合治疗的患者进行了回顾性多中心队列研究.
- 使用CTCAE v.5,NCC MERP指数和SITC共识标准对irAEs的评估.
- 对irAE发生率,严重程度,慢性和结果的分析.
主要成果:
- 在612名患者中,有40%的患者经历了irrAEs,在特定的患者群体和治疗方案中发生率更高.
- 严重的irrAEs导致50%的受影响患者停止治疗和住院治疗.
- 慢性IRAE是常见的,许多持续超过三个月,致命IRAE发生在16名患者中.
结论:
- 在评估irAE临床后果和长期影响方面,NCC MERP和SITC标准比CTCAE具有优势.
- 严重和慢性IREs是常见的,需要改进的管理策略.
- 需要进行前性研究,修订毒性定义,以加强irAE评估和患者护理.
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