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免疫检查点抑制剂诱导的皮肤不良反应的回顾性观察研究。

A retrospective observational study on cutaneous adverse events induced by immune checkpoint inhibitors.

机构信息

Unit of Skin Cancer, IRCCS Istituto Romagnolo per lo Studio dei Tumori Dino Amadori, IRST, Meldola, Forlì-Cesena, Italy.

Unit of Skin Cancer, IRCCS Istituto Romagnolo per lo Studio dei Tumori Dino Amadori, IRST, Meldola, Forlì-Cesena, Italy -

出版信息

Ital J Dermatol Venerol. 2023 Dec;158(6):437-444. doi: 10.23736/S2784-8671.23.07542-4.

Abstract

BACKGROUND

Cutaneous adverse events (CAEs) related to oncological therapies are a common scenario in daily clinical practice.

METHODS

This is a retrospective observational study collecting the data regarding CAEs of patients treated with immune checkpoints inhibitors (ICIs) in four different Italian centers.

RESULTS

Of 323 patients included, 305 were evaluable for this analysis; 182 patients (59.7%) had metastatic cutaneous melanoma (CM), 99 (32.5%) non-small cell lung cancer (NSCLC) and 24 (7.8%) renal cell carcinoma (RCC). The most frequent CAEs that we found, considering all the 305 patients, were pruriginous maculopapular rash (10.2% of the patients), vitiligo-like areas (7.2% of the patients), psoriasiform rash (6.2% of the patients), asymptomatic maculopapular rash (4.6% of the patients), and lichenoid rash (4.3% of the patients). Vitiligo-like areas occurred more frequently in patients with CM, while a lichenoid rash was more frequently observed in patients with RCC. Treatment interruption was related to drug-induced CAEs in 15.4% of melanoma patients and 0.0% of lung and kidney patients. Patients developing a cutaneous adverse event had better overall response rate and higher progression free survival and overall survival than the patients without CAEs.

CONCLUSIONS

Our study brings new information on the characteristics of CAEs related to ICIs treatment in three different types of cancers, CM, NSCLC and RCC.

摘要

背景

与肿瘤治疗相关的皮肤不良反应(CAEs)是日常临床实践中的常见情况。

方法

这是一项回顾性观察性研究,收集了在意大利的四个不同中心接受免疫检查点抑制剂(ICIs)治疗的患者的 CAE 数据。

结果

在纳入的 323 名患者中,有 305 名患者可用于本分析;182 名(59.7%)患者患有转移性皮肤黑色素瘤(CM),99 名(32.5%)患有非小细胞肺癌(NSCLC),24 名(7.8%)患有肾细胞癌(RCC)。在考虑所有 305 名患者的情况下,我们发现最常见的 CAEs 是瘙痒性斑丘疹(10.2%的患者)、白癜风样区域(7.2%的患者)、银屑病样皮疹(6.2%的患者)、无症状斑丘疹(4.6%的患者)和苔藓样皮疹(4.3%的患者)。白癜风样区域在 CM 患者中更为常见,而苔藓样皮疹在 RCC 患者中更为常见。在 15.4%的黑色素瘤患者中,药物引起的 CAEs 与治疗中断有关,而在肺和肾患者中则为 0.0%。发生皮肤不良反应的患者比没有 CAEs 的患者具有更好的总体反应率、更高的无进展生存期和总生存期。

结论

我们的研究为三种不同类型的癌症(CM、NSCLC 和 RCC)中与 ICIs 治疗相关的 CAEs 的特征提供了新信息。

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