Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Respir Med. 2020 Jan;161:105853. doi: 10.1016/j.rmed.2019.105853. Epub 2019 Dec 14.
Limited data exist on the development of tuberculosis (TB) in cancer patients receiving immune checkpoint inhibitors (ICIs).
s: We evaluated the development of TB in 1144 solid-cancer patients who started ICIs (pembrolizumab, nivolumab, or atezolizumab) between July 2014 and December 2018.
A total of 1144 cancer patients were treated with ICIs. The median age of the patients at the start of ICI treatment was 62 years (interquartile range [IQR]; 53-69 years). Lung cancer (n = 796, 69.6%) was the most common cancer followed by melanoma (n = 115, 10.1%), and lymphoma (n = 85, 7.4%). Pembrolizumab (n = 612, 53.5%) was the most common treatment, followed by nivolumab (n = 474, 41.4%) and atezolizumab (n = 58, 5.1%). The median treatment duration with ICIs was 42 days (IQR; 18-154 days), and the median follow-up duration after initiating ICIs was 187 days (IQR; 70-342 days). Overall, three patients developed TB, two of whom received nivolumab and one who received pembrolizumab.
Our data showed that TB can develop in cancer patients receiving ICIs. However, due to the small number of study population, it is insufficient to draw accurate conclusions about the role of ICIs in the development of TB. Moreover, it is unclear whether the incidence of TB would be comparable with the incidence of TB in elderly cancer patients. Further studies are needed to evaluate whether diagnosis and treatment of latent TB infections before starting ICIs could be helpful in preventing the development of TB in these patients.
在接受免疫检查点抑制剂（ICI）治疗的癌症患者中，结核病（TB）的发展数据有限。
我们评估了 1144 例在 2014 年 7 月至 2018 年 12 月期间开始接受 ICI（派姆单抗、纳武单抗或阿特珠单抗）治疗的实体瘤患者中 TB 的发展情况。
共有 1144 例癌症患者接受了 ICI 治疗。ICI 治疗开始时患者的中位年龄为 62 岁（四分位距 [IQR]；53-69 岁）。肺癌（n=796，69.6%）是最常见的癌症，其次是黑色素瘤（n=115，10.1%）和淋巴瘤（n=85，7.4%）。派姆单抗（n=612，53.5%）是最常见的治疗药物，其次是纳武单抗（n=474，41.4%）和阿特珠单抗（n=58，5.1%）。ICI 治疗的中位持续时间为 42 天（IQR；18-154 天），ICI 治疗开始后中位随访时间为 187 天（IQR；70-342 天）。总体而言，有 3 例患者发生了 TB，其中 2 例接受了纳武单抗治疗，1 例接受了派姆单抗治疗。
我们的数据表明，接受 ICI 治疗的癌症患者可能会发生 TB。然而，由于研究人群数量较少，尚不足以得出关于 ICI 在 TB 发展中的作用的准确结论。此外，尚不清楚 TB 的发生率是否与老年癌症患者的 TB 发生率相当。需要进一步的研究来评估在开始 ICI 治疗之前诊断和治疗潜伏性 TB 感染是否有助于预防这些患者发生 TB。
