Taoka Masataka, Ochi Nobuaki, Yamane Hiromichi, Yamamoto Takenobu, Kawahara Tatsuyuki, Uji Emiko, Kosaka Youko, Takeda Kouhei, Nagasaki Yasunari, Nakanishi Hidekazu, Aoyama Yumi, Takigawa Nagio
Department of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan.
Department of Dermatology, Kawasaki Medical School, Kurashiki, Japan.
Transl Cancer Res. 2022 Mar;11(3):456-462. doi: 10.21037/tcr-21-2764.
Herpes zoster (HZ) occurs mostly in elderly and immunocompromised individuals. Immune reconstitution may be associated with the pathogenesis of HZ. As immune checkpoint inhibitor (ICI) treatment amplifies the immune response, use of ICI may increase the incidence of HZ. There have been few studies of HZ in lung cancer patients treated with ICI. This study was performed to investigate the frequency of HZ in lung cancer patients who received ICI or cytotoxic chemotherapeutic agents.
We searched the electronic medical records for lung cancer patients receiving anticancer drug therapy at our hospital, who developed HZ between April 2011 and June 2020.
The review identified 80 patients with a history of ICI treatment (ICI group) and 356 who had been treated with cytotoxic chemotherapeutic agents alone (non-ICI group). Among the 20 patients who developed HZ, 4 (5.0%) belonged to the ICI group and 16 (4.5%) to the non-ICI group (P=0.782). After exclusion of patients aged 65 years and older, to avoid effects of advanced age on the results, the ICI and non-ICI groups consisted of 24 and 81 patients, respectively. In total, 3 of the 24 patients (12.5%) in the ICI group and 1 of the 81 (1.2%) patients in the non-ICI group developed HZ (P=0.0365).
There was no significant difference in the rate of HZ between lung cancer patients treated with ICI and those treated with cytotoxic chemotherapy alone. However, patients younger than 65 years treated with ICI might be at increased risk of HZ. Because this is a retrospective small study, further prospective observational studies are needed.
带状疱疹（HZ）大多发生于老年人和免疫功能低下者。免疫重建可能与HZ的发病机制有关。由于免疫检查点抑制剂（ICI）治疗会放大免疫反应，使用ICI可能会增加HZ的发病率。关于接受ICI治疗的肺癌患者发生HZ的研究较少。本研究旨在调查接受ICI或细胞毒性化疗药物治疗的肺癌患者中HZ的发生频率。
我们在本院的电子病历中搜索了2011年4月至2020年6月期间接受抗癌药物治疗并发生HZ的肺癌患者。
该回顾性研究确定了80例有ICI治疗史的患者（ICI组）和356例仅接受细胞毒性化疗药物治疗的患者（非ICI组）。在发生HZ的20例患者中，4例（5.0%）属于ICI组，16例（4.5%）属于非ICI组（P=0.782）。为避免高龄对结果的影响，排除65岁及以上患者后，ICI组和非ICI组分别有24例和81例患者。ICI组24例患者中有3例（12.5%）发生HZ，非ICI组81例患者中有1例（1.2%）发生HZ（P=0.0365）。
接受ICI治疗的肺癌患者与仅接受细胞毒性化疗的肺癌患者的HZ发生率无显著差异。然而，接受ICI治疗的65岁以下患者发生HZ的风险可能增加。由于这是一项回顾性小型研究，需要进一步进行前瞻性观察研究。
