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癌症患者免疫相关不良事件预测模型的开发

Development of a predictive model for immune‑related adverse events in patients with cancer.

作者信息

Tang Yajuan, Shi Jinping, Wang Liping, Zhang Yan, Xu Liting, Sun Tao

机构信息

Department of Pharmacy, Xi'an International Medical Center Hospital, Xi'an, Shaanxi 710100, P.R. China.

Department of Pharmacy, The Second Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi 710038, P.R. China.

出版信息

Oncol Lett. 2024 Dec 17;29(3):103. doi: 10.3892/ol.2024.14849. eCollection 2025 Mar.

Abstract

It is crucial to accurately identify patients with cancer at high risk for immune-related adverse events (irAEs) caused by immune checkpoint inhibitors (ICIs). The present retrospective study analyzed the risk factors for irAEs in 992 patients with cancer treated with ICIs at Xi'an International Medical Center Hospital from December 2021 to December 2023. The patients were categorized into one group that experienced irAEs (n=276) and a control group (n=716) based on the occurrence of irAEs. The clinical characteristics of irAEs group (n=276) and control group (n=716) were analyzed to identify the risk factors of irAEs in patients with cancer. Multivariate regression analysis revealed significant differences between the two groups in terms of hypertension, primary cancer, metastasis, targeted drug combination and radiotherapy (P<0.05). A nomogram predictive model for irAEs was developed based on the relevant risk factors. The predictive model for irAEs in patients with cancer yielded an area under the receiver operating characteristic (ROC) curve of 0.672 (95% confidence interval: 0.630-0.714). In the validation set, the Hosmer-Lemeshow goodness-of-fit test demonstrated a favorable fit with a chi-square value of 0.787 and a P-value of 0.978. The developed predictive model can effectively identify high-risk patients with irAEs, facilitate early identification of irAEs, thereby optimizing the management strategies of irAEs, and ultimately improving the quality of life for patients.

摘要

准确识别癌症患者中因免疫检查点抑制剂(ICI)导致免疫相关不良事件(irAE)的高风险患者至关重要。本回顾性研究分析了2021年12月至2023年12月在西安国际医学中心医院接受ICI治疗的992例癌症患者发生irAE的风险因素。根据irAE的发生情况,将患者分为发生irAE的一组(n = 276)和对照组(n = 716)。分析irAE组(n = 276)和对照组(n = 716)的临床特征,以确定癌症患者发生irAE的风险因素。多因素回归分析显示,两组在高血压、原发性癌症、转移、靶向药物联合使用和放疗方面存在显著差异(P<0.05)。基于相关风险因素建立了irAE的列线图预测模型。癌症患者irAE的预测模型在受试者工作特征(ROC)曲线下的面积为0.672(95%置信区间:0.630 - 0.714)。在验证集中,Hosmer-Lemeshow拟合优度检验显示拟合良好,卡方值为0.787,P值为0.978。所建立的预测模型可以有效识别irAE的高风险患者,促进irAE的早期识别,从而优化irAE的管理策略,最终提高患者的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52c9/11683521/569f94f5c53a/ol-29-03-14849-g00.jpg

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