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一项回顾性队列研究,评估癌症患者接受免疫检查点抑制剂治疗后的多种免疫相关不良事件与临床结局。

A Retrospective Cohort Study of Multiple Immune-Related Adverse Events and Clinical Outcomes Among Patients With Cancer Receiving Immune Checkpoint Inhibitors.

机构信息

Education and Research Center for Clinical Pharmacy, 12916Kyoto Pharmaceutical University, Kyoto, Japan.

Department of Pharmacy, 13707National Hospital Organization Osaka National Hospital, Osaka, Japan.

出版信息

Cancer Control. 2022 Jan-Dec;29:10732748221130576. doi: 10.1177/10732748221130576.

Abstract

BACKGROUND AND OBJECTIVES

Immune checkpoint inhibitors (ICIs) are effective in various types of cancer and cause immune-related adverse events (irAEs). The occurrence of irAEs is associated with improved survival outcome. We investigated the association between the occurrence of irAEs and overall survival (OS) and progression free survival (PFS), and the risk factors for the development of irAEs, in patients with non-small-cell lung cancer (NSCLC), gastric cancer (GC) and melanoma (MM) treated with ICIs.

METHODS

This was a retrospective observational cohort study, and the data were taken from inpatients in a hospital. OS and PFS were compared among patients with different numbers of irAEs. Log-rank test and Cox regression and logistic regression analysis were applied, and details of irAEs characteristics were summarized.

RESULTS

We obtained data from 200 patients. The major tumor types were NSCLC, GC, and MM. Median OS and PFS in all patients were 9.3 and 3.5 months, respectively. Patients without irAEs tended to have shorter OS or PFS compared with those with a single irAE or multi-system irAEs. Covariate analysis suggested that age (≥75 years), albumin (≥3.5 g/dL) and smoking history were significant for increased occurrence of irAEs. Pneumonitis and thyroiditis tended to occur frequently in patients with NSCLC and MM. The irAE grade was ≤2 in 67.3% of all irAEs, and days of irAEs onset varied.

CONCLUSION

We observed patients with irAEs tended to have better OS or PFS in patients with various types of cancers treated with ICIs. We suggest that ICIs should be used appropriately by continuously monitoring the irAEs.

摘要

背景与目的

免疫检查点抑制剂(ICIs)在多种类型的癌症中具有疗效,并引起免疫相关不良反应(irAEs)。irAEs 的发生与改善生存结局相关。我们研究了 irAEs 的发生与非小细胞肺癌(NSCLC)、胃癌(GC)和黑色素瘤(MM)患者的总生存(OS)和无进展生存(PFS)之间的关联,以及这些患者发生 irAEs 的风险因素。

方法

这是一项回顾性观察性队列研究,数据来自医院的住院患者。我们比较了不同 irAEs 数量患者的 OS 和 PFS。应用 Log-rank 检验、Cox 回归和 logistic 回归分析,并总结了 irAEs 特征的详细信息。

结果

我们从 200 名患者中获得了数据。主要肿瘤类型为 NSCLC、GC 和 MM。所有患者的中位 OS 和 PFS 分别为 9.3 个月和 3.5 个月。与发生单一 irAE 或多系统 irAEs 的患者相比,无 irAEs 的患者 OS 或 PFS 更短。协变量分析表明,年龄(≥75 岁)、白蛋白(≥3.5 g/dL)和吸烟史是 irAEs 发生的显著因素。肺炎和甲状腺炎在 NSCLC 和 MM 患者中更常见。所有 irAEs 中,irAE 分级≤2 的占 67.3%,irAEs 发病天数不同。

结论

我们观察到,在接受 ICI 治疗的各种类型癌症患者中,发生 irAEs 的患者 OS 或 PFS 更好。我们建议通过持续监测 irAEs 来适当使用 ICI。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5599/9583223/d4317ef93388/10.1177_10732748221130576-fig1.jpg

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