Department of Pharmacy, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
J Coll Physicians Surg Pak. 2024 Mar;34(3):302-307. doi: 10.29271/jcpsp.2024.03.302.
To investigate the clinical characteristics, treatment methods, outcomes, and variables influencing the outcomes of checkpoint inhibitor-related pneumonitis (CIP) among Chinese cancer patients.
Descriptive Study. Place and Duration of the Study: Department of Pharmacy, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China, from January 2019 to December 2022.
Patients with CIP were inducted. Clinical data including patient characteristics, ICI protocols; and the clinical features, treatments, and outcomes of CIP were collected and analysed.
One hundred and forty-six patients were included. Median time to onset in the CIP was 17.0 weeks (range: 0.4 - 74.7). Mild CIP and severe CIP accounted for 84.93% and 15.07% of cases, respectively. All patients with CIP received methylprednisolone treatment, with an average starting dose of 1.64 mg/kg (0.59-6.00 mg/kg), and 79 (54.11%) of them received anti-infective therapy. One hundred and thirteen (77.04%) patients had improved symptoms of pneumonia, with only 33 (22.60%) patients displaying no improvement. Multivariate analysis revealed that the severity of CIP [OR = 0.167 (95% CI 0.061-0.461), p <0.001] and the starting dose of methylprednisolone [OR = 0.314 (95% CI 0.129-0.764), p <0.001] were independent predictors of outcomes of CIP, while the use of antibiotic was not.
The severity of CIP and the initial dosage of methylprednisolone administered are significant factors that impact the outcomes of CIP in Chinese cancer patients after ICI treatment. Appropriate use of glucocorticoids and antibiotics is a necessary management strategy to control CIP effectively.
Immune checkpoint inhibitors, Immune-related adverse events, Checkpoint inhibitor-related pneumonitis, Glucocorticosteroids, Antibiotics, Prognostic factors.
探讨中国癌症患者接受免疫检查点抑制剂（ICI）治疗后发生免疫检查点抑制剂相关肺炎（CIP）的临床特征、治疗方法、结局以及影响结局的因素。
描述性研究。研究地点和时间：湖南省肿瘤医院药学部，中南大学湘雅医学院附属肿瘤医院，中国长沙，2019 年 1 月至 2022 年 12 月。
纳入 CIP 患者，收集患者特征、ICI 方案以及 CIP 的临床特征、治疗和结局等临床资料进行分析。
共纳入 146 例患者，CIP 的中位发病时间为 17.0 周（范围：0.4-74.7）。轻度 CIP 和重度 CIP 分别占 84.93%和 15.07%。所有 CIP 患者均接受甲泼尼龙治疗，平均起始剂量为 1.64mg/kg（0.59-6.00mg/kg），79 例（54.11%）患者接受抗感染治疗。113 例（77.04%）患者肺炎症状改善，仅 33 例（22.60%）患者症状无改善。多因素分析显示，CIP 严重程度[比值比（OR）=0.167（95%可信区间 0.061-0.461），p<0.001]和甲泼尼龙起始剂量[OR=0.314（95%可信区间 0.129-0.764），p<0.001]是影响 CIP 结局的独立预测因素，而抗生素的使用则不是。
CIP 严重程度和甲泼尼龙起始剂量是影响中国癌症患者接受 ICI 治疗后 CIP 结局的重要因素。合理使用糖皮质激素和抗生素是有效控制 CIP 的必要管理策略。
免疫检查点抑制剂；免疫相关不良反应；免疫检查点抑制剂相关肺炎；糖皮质激素；抗生素；预后因素。
