在I-SPY临床试验中识别与随后的免疫相关不良事件相关的早期症状
Research square
|February 23, 2026
概括
疲劳和皮疹等早期症状可以预测甲状腺功能低下症,而腹和便秘可能在接受免疫治疗的患者中信号上腺功能不足 (AI). 这项研究有助于早期检测免疫相关不良事件 (irAEs).
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 内分泌学 在内分泌学.
背景情况:
- 免疫检查点抑制剂 (ICI) 可以导致严重的,持久的免疫相关不良事件 (irAEs).
- 早期识别预测irAEs的症状对于及时监测和干预至关重要.
- 这项研究的重点是预测乳腺癌患者的irAEs,特别是上腺功能衰竭 (AI) 和甲状腺功能低下症.
研究的目的:
- 评估ICI治疗前8周内的症状是否可以预测随后的AI或甲状腺功能低下症.
- 开发一种预测模型,用于识别患有这些特定irrAEs风险的患者.
主要方法:
- 使用从I-SPY2试验中前性收集的数据 (482名患有II/III期高风险乳腺癌的女性) 的回顾性队列研究.
- 分析症状和irAEs (甲状腺功能低下症,AI) 使用常用术语对不良事件的标准.
- 使用后勤回归和ROC分析进行预测建模,症状负担量化为曲线下的面积 (AUC).
主要成果:
- 在482名参与者中,有107名 (22.2%) 患有irrAEs;甲状腺功能低下 (12.7%) 和AI (7.9%) 是最常见的.
- 疲劳和皮疹预测甲状腺功能低下;腹,便秘和味道变化与AI有关.
- 预测模型显示中等性能 (甲状腺功能低下的AUC为0.61,AI为0.65) 在验证中准确度为72.8%-74.7%.
结论:
- 使用早期症状的预测框架可以将AI和甲状腺功能低下风险的患者识别为irAEs.
- 这一框架使个性化护理和积极的干预措施能够改善治疗结果和患者安全.
- 早期症状监测是管理乳腺癌患者ICI相关毒性的关键.
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