Saowapa Sakditad, Polpichai Natchaya, Tanariyakul Manasawee, Wannaphut Chalothorn, Wattanachayakul Phuuwadith, Danpanichkul Pojsakorn, Suenghataiphorn Thanathip, Kulthamrongsri Narathorn, Siladech Pharit, Tijani Lukman
Department of Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.
Department of Internal Medicine, Weiss Memorial Hospital, Chicago, Illinois, USA.
Proc (Bayl Univ Med Cent). 2024 Jul 8;37(5):841-850. doi: 10.1080/08998280.2024.2374161. eCollection 2024.
Recent advances in immunotherapy using immune checkpoint inhibitors (ICIs) for various cancers have also highlighted a rise in immune-related adverse events, including hepatitis, potentially leading to the discontinuation of treatment. This study aimed to evaluate the prevalence of hepatitis in metastatic colorectal cancer (mCRC) patients undergoing different ICI therapies. An extensive search of PubMed, PubMed Central, and Google Scholar up to November 2023 identified relevant studies. After excluding non-English articles, case reports, reviews, ongoing trials, and studies combining other therapies, five studies qualified for inclusion. Data extraction and statistical analyses were performed using Excel and Comprehensive Meta-Analysis software, respectively. Results from a subgroup analysis indicated that the incidence of hepatitis was comparable among patients treated with PD-1 monotherapy, PDL-1 monotherapy, and combination PD-1 and CTLA-4 therapy, with rates of 2.6%, 2.2%, and 1.7% for any grade and 2.1%, 2.2%, and 1.7% for grade ≥3 hepatitis, respectively. Naive-treated mCRC patients exhibited higher hepatitis rates than those previously treated (3.2% vs 1.6% and 2.6% vs 1.6% for any grade and grade ≥3, respectively). This study underscores the similar risk of hepatitis across different ICI therapies, with an increased incidence in naive-treated mCRC patients.
使用免疫检查点抑制剂（ICI）治疗各种癌症的免疫疗法的最新进展也凸显了免疫相关不良事件的增加，包括肝炎，这可能导致治疗中断。本研究旨在评估接受不同ICI治疗的转移性结直肠癌（mCRC）患者中肝炎的患病率。对截至2023年11月的PubMed、PubMed Central和谷歌学术进行广泛检索，确定了相关研究。在排除非英文文章、病例报告、综述、正在进行的试验以及结合其他疗法的研究后，五项研究符合纳入标准。分别使用Excel和Comprehensive Meta-Analysis软件进行数据提取和统计分析。亚组分析结果表明，接受PD-1单药治疗、PDL-1单药治疗以及PD-1与CTLA-4联合治疗的患者中，肝炎的发生率相当，任何级别肝炎的发生率分别为2.6%、2.2%和1.7%，≥3级肝炎的发生率分别为2.1%、2.2%和1.7%。初治mCRC患者的肝炎发生率高于既往治疗患者（任何级别肝炎分别为3.2%对1.6%，≥3级肝炎分别为2.6%对1.6%）。本研究强调了不同ICI治疗中肝炎风险相似，初治mCRC患者的发生率更高。
