Agarwal Kapil, Yousaf Nadia, Morganstein Daniel
Imperial College, London, UK.
Royal Marsden Hospital, London, UK.
Clin Med (Lond). 2020 Mar;20(2):163-168. doi: 10.7861/clinmed.2018-0440.
Immune checkpoint inhibitors have demonstrated benefit in the treatment of cancer, but are associated with toxicities, which often require treatment with glucocorticoids.
We aimed to determine the prevalence of glucocorticoid use in patients treated with immune checkpoint inhibitors for melanoma in a single centre.
We performed a retrospective review of patients with advanced melanoma treated with an immune checkpoint inhibitor between September 2010 and January 2017. Patients treated with glucocorticoids had a cumulative dose and duration of glucocorticoid treatment calculated. New onset hyperglycaemia was also identified.
Of 412 patients receiving immune checkpoint therapy, 157 (38%) required glucocorticoids to treat toxicities. The median cumulative glucocorticoid dose was 2,795 mg (prednisolone equivalent) with a median duration of 61 days. Twenty-seven patients receiving glucocorticoids were noted to develop new onset hyperglycaemia.
Immune-related adverse events frequently occur in patients treated with immune checkpoint inhibitors. Consequently, patients receive prolonged courses of glucocorticoids. Awareness of glucocorticoid-induced side effects is required.
免疫检查点抑制剂已在癌症治疗中显示出疗效，但会引发毒性反应，这通常需要使用糖皮质激素进行治疗。
我们旨在确定在单一中心接受免疫检查点抑制剂治疗黑色素瘤的患者中使用糖皮质激素的比例。
我们对2010年9月至2017年1月期间接受免疫检查点抑制剂治疗的晚期黑色素瘤患者进行了回顾性研究。计算了接受糖皮质激素治疗的患者的糖皮质激素累积剂量和治疗持续时间。还确定了新发高血糖症。
在412例接受免疫检查点治疗的患者中，157例（38%）需要使用糖皮质激素来治疗毒性反应。糖皮质激素的中位累积剂量为2795毫克（相当于泼尼松龙），中位持续时间为61天。注意到27例接受糖皮质激素治疗的患者出现了新发高血糖症。
接受免疫检查点抑制剂治疗的患者经常发生免疫相关不良事件。因此，患者需要长期使用糖皮质激素疗程。需要了解糖皮质激素引起的副作用。
