甲酸莫菲蒂尔用于治疗Ipilimumab诱导的大肠炎在患有转移性黑色素瘤的患者
Christina Naoum1, Julia K Winkler1, Pawel Majenka1
1Department of Dermatology and National Center for Tumor Diseases (NCT), Medical Faculty Heidelberg, Heidelberg University, NCT Heidelberg, A Partnership Between DKFZ and University Hospital Heidelberg, 69117 Heidelberg, Germany.
Cancers
|March 14, 2026
概括
菌酸莫菲提尔 (MMF) 提供了一个耐受良好的口服替代品,用于管理免疫检查点抑制剂 (ICI) 诱导的免疫相关结肠炎,在耐固醇患者中显示出与因弗力西马布 (infliximab) 相似的疗效.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 胃肠病学 胃肠病学
背景情况:
- 免疫检查点抑制剂 (ICI) 改善了晚期黑色素瘤的结果,但可能导致与免疫相关的不良事件 (irAEs).
- 免疫相关 (IR) 大肠炎是一种常见的严重IRAE,通常用皮质类固醇治疗.
- 类固醇耐药病例通常需要额外的免疫抑制剂,因弗力西马布是常见的选择,对甲酸莫菲蒂尔 (MMF) 的数据有限.
研究的目的:
- 为了比较MMF与infliximab的疗效和安全性,作为治疗类固醇耐药ICI诱导性肠道结肠炎的额外免疫抑制剂.
- 评估临床结果,包括响应率,响应时间,类固醇使用和生存率.
主要方法:
- 对52名患有ICI诱导性肠道结肠炎的类固醇耐药患者的回顾性分析.
- 31名患者接受了MMF,21名患者接受了infliximab.
- 测量结果:反应率,反应时间,类固醇摄入量,大肠炎复发,无进展生存期 (PFS) 和整体生存期 (OS).
主要成果:
- 无论是MMF (77.4%) 还是infliximab (95.2%) 都实现了症状缓解,反应时间相似.
- 两组之间没有观察到大肠炎复发或CMV阳性的显著差异.
- 货币货币基金组织 (MMF) 组显示治疗持续时间更长和累计皮质类固醇摄入量显著增加的趋势,可能受中心特定策略的影响.
结论:
- MMF是一种耐受性良好的口服治疗选择,用于ICI诱导的肠道结肠炎.
- 对于患有对因弗利克西马布的禁忌的患者来说,MMF特别有价值.
- 进一步的研究可能会澄清最佳管理策略和长期结果.
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