Frey Connor, Etminan Mahyar
Department of Medicine, University of British Columbia, 317-2194 Health Sciences Mall, Vancouver, BC V6T 1Z3, Canada.
Department of Ophthalmology and Visual Sciences, University of British Columbia, 2550 Willow Street, Vancouver, BC V5Z 3N9, Canada.
Antibodies (Basel). 2024 Jul 15;13(3):56. doi: 10.3390/antib13030056.
The advancement of immuno-oncology has brought about a significant shift in cancer treatment methods, with antibody-based immune checkpoint inhibitors like atezolizumab leading the way in this regard. However, the use of this checkpoint blockade can result in immune-related adverse events due to increased T-cell activity. The full spectrum of these events is not yet completely understood. In this study, the United States FDA Adverse Event Reporting System (FAERS) was utilized to investigate immune-related adverse events linked with the use of atezolizumab. The study identified forty-nine immune-related adverse events that affected multiple organ systems, including cardiovascular, respiratory, hematologic, hepatic, renal, gastrointestinal, neurologic, musculoskeletal, dermatologic, endocrine, and systemic disorders. The strongest signals for relative risk occurred for immune-mediated encephalitis (RR = 93.443), autoimmune myocarditis (RR = 56.641), immune-mediated hepatitis (RR = 49.062), immune-mediated nephritis (RR = 40.947), and autoimmune arthritis (RR = 39.382). Despite the morbidity associated with these adverse events, emerging evidence suggests potential associations with improved survival outcomes. Overall, this report sheds light on the widespread immune-related adverse events that cause significant morbidity and mortality in patients with cancer being treated with atezolizumab and brings attention to them for the clinicians treating these patients.
免疫肿瘤学的进展使癌症治疗方法发生了重大转变，以阿替利珠单抗等基于抗体的免疫检查点抑制剂在这方面引领潮流。然而，由于T细胞活性增加，使用这种检查点阻断可能导致免疫相关不良事件。这些事件的全貌尚未完全了解。在本研究中，美国食品药品监督管理局不良事件报告系统（FAERS）被用于调查与使用阿替利珠单抗相关的免疫相关不良事件。该研究确定了49种影响多个器官系统的免疫相关不良事件，包括心血管、呼吸、血液、肝脏、肾脏、胃肠道、神经、肌肉骨骼、皮肤、内分泌和全身疾病。免疫介导性脑炎（RR = 93.443）、自身免疫性心肌炎（RR = 56.641）、免疫介导性肝炎（RR = 49.062）、免疫介导性肾炎（RR = 40.947）和自身免疫性关节炎（RR = 39.382）的相对风险信号最强。尽管这些不良事件存在发病率，但新出现的证据表明它们与生存结果改善存在潜在关联。总体而言，本报告揭示了在接受阿替利珠单抗治疗的癌症患者中导致显著发病率和死亡率的广泛免疫相关不良事件，并引起治疗这些患者的临床医生对它们的关注。
