风险因素和预测模型的早期发病的免疫相关的不良事件在泛癌患者接受抗PD-(L) 1疗法:在三级医院的回顾性研究
Panpan Jiao1,2, Lijuan Xue1, Weijuan Tan1
1Department of Oncology, Zhongshan Hospital Affiliated to Xiamen University, Xiamen, Fujian, China.
Cancer medicine
|February 10, 2026
概括
预测抗PD-(L) 1免疫疗法的免疫相关不良事件 (irAEs) 是至关重要的. 使用常规血液检查和临床因素的新模型可以识别高风险患者进行早期干预.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 医疗信息学 医疗信息学
背景情况:
- 反编程死亡1 (PD-1) 和反编程死亡联体1 (PD-L1) 免疫检查点抑制剂 (ICI) 已经彻底改变了癌症治疗.
- 与免疫相关的不良事件 (irAEs) 对ICI的临床益处构成重大挑战.
- 预测IREs对于及时检测和管理至关重要.
研究的目的:
- 开发和验证在接受抗PD-(L) 1免疫治疗的患者中对irAEs的预测模型.
- 确定与irAE发展相关的关键临床和实验室参数.
主要方法:
- 用10倍交叉验证的物流最小绝对收缩和选择操作员 (LASSO) 回归来选择相关变量.
- 多变量逻辑回归分析被用来构建预测模型.
- 从2019年1月到2023年5月的患者数据被追溯分析.
主要成果:
- 总共有680名患者被纳入,其中330人经历了irAEs.
- 内分泌毒性是最常见的IRE (25.59%).
- 开发的风险模型,包括基细胞百分比,血红蛋白,ALC,PLR,LMR,BUN,CCI,ECOG PS和B型肝炎状态,显示出良好的预测性能 (C指数=0.727).
结论:
- 已建立的预测模型可以有效地选和监测易RAEs高风险患者.
- 这种工具有可能改善接受抗PD-(L) 1治疗的胰腺癌患者的治疗结果.
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