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评估 PD-1/PD-L1 抑制剂在 COVID-19 感染后恶性肿瘤患者免疫治疗中的安全性:一项单中心队列研究。

Evaluation of the safety of PD-1/PD-L1 inhibitors for immunotherapy in patients with malignant tumors after COVID-19 infection: A single-center cohort study.

机构信息

Department of Clinical Laboratory, the 2nd Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.

School of Public Health, Jiangxi Medical College, Nanchang University, Nanchang, China.

出版信息

Cancer Med. 2024 Oct;13(19):e70202. doi: 10.1002/cam4.70202.

Abstract

INTRODUCTION

An increasing body of evidence suggests a close association between COVID-19 infection and the safety of PD-1/PD-L1 inhibitor therapy in cancer patients. However, the available data concerning these impacts remain limited and occasionally contradictory.

MATERIAL AND METHODS

We conducted a retrospective analysis of cancer patients who received PD-1/PD-L1 inhibitor therapy at the same institution from November 2022 to May 2023. After excluding patients with missing information, a total of 224 cases were included. In our study, immune-related adverse events (irAEs) that occurred during the hospitalization of patients were included in the analysis. Further analysis of inter-subgroup differences was conducted following a 1:2 propensity score matching. Statistical analyses were performed using the Fisher's exact, chi-squared, and Mann-Whitney U-tests.

RESULT

The results showed that no statistically significant differences between the two subgroups in the incidence of irAEs, changes in immune function before and after using PD-1/PD-L1 inhibitors, and alterations in hepatic and renal function (p > 0.05).

CONCLUSION

Our findings suggest that infection with COVID-19 does not significantly impact the safety of PD-1/PD-L1 inhibitors in cancer patients. Most cancer patients used PD-1/PD-L1 inhibitors during COVID-19 infection (asymptomatic or mild infection) did not experience exacerbation of their underlying condition, nor did they exhibit a substantial increase in toxic side effects.

摘要

介绍

越来越多的证据表明,COVID-19 感染与癌症患者接受 PD-1/PD-L1 抑制剂治疗的安全性密切相关。然而,关于这些影响的可用数据仍然有限,且偶尔存在矛盾。

材料与方法

我们对 2022 年 11 月至 2023 年 5 月期间在同一机构接受 PD-1/PD-L1 抑制剂治疗的癌症患者进行了回顾性分析。排除信息缺失的患者后,共纳入 224 例患者。在本研究中,我们分析了患者住院期间发生的免疫相关不良事件(irAEs)。随后,采用 1:2 倾向评分匹配对亚组间差异进行了进一步分析。采用 Fisher 精确检验、卡方检验和 Mann-Whitney U 检验进行统计学分析。

结果

结果显示,两组间 irAEs 的发生率、使用 PD-1/PD-L1 抑制剂前后免疫功能的变化以及肝肾功能的改变均无统计学差异(p>0.05)。

结论

我们的研究结果表明,COVID-19 感染不会显著影响癌症患者使用 PD-1/PD-L1 抑制剂的安全性。大多数癌症患者在 COVID-19 感染期间(无症状或轻度感染)使用 PD-1/PD-L1 抑制剂并未导致基础疾病恶化,也未出现毒性副作用显著增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b12/11459677/d0843f845cfe/CAM4-13-e70202-g002.jpg

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