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韩国癌症患者中免疫检查点抑制剂诱发结肠炎的发病率及危险因素

Incidence and risk factors of immune checkpoint inhibitor-induced colitis in Korean patients with cancer.

作者信息

Kim Tae Kyun, Lee Hyun Seok, Kim Eun Soo

机构信息

Department of Internal Medicine, Kyungpook National University Chilgok Hospital, Daegu, Korea.

Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.

出版信息

Korean J Intern Med. 2025 Jan;40(1):49-56. doi: 10.3904/kjim.2024.135. Epub 2025 Jan 1.

Abstract

BACKGROUND/AIMS: Immune checkpoint inhibitors (ICIs) are effective in treating cancer. However, various immune-related adverse events (irAEs) have become prevalent, with ICI-induced colitis being the most common gastrointestinal irAE. Thus, we aimed to investigate the incidence and risk factors of ICI-induced colitis in Korean patients with cancer.

METHODS

This retrospective study included patients treated with ICIs between October 2015 and June 2022 in two tertiary referral centers in Daegu, Korea. The incidence of ICI-induced colitis was determined using electronic medical records. Risk factors for ICI-induced colitis were identified using univariate and multivariate logistic regression analyses.

RESULTS

We included 1,478 patients with ICI-treated cancer. The incidence of ICI-induced colitis was 3.5% (n = 52/1,478). Multivariate logistic regression analysis showed that the combination of nivolumab and ipilimumab was a risk factor for ICI-induced colitis (p = 0.006; odds ratio, 9.768; 95% confidence interval, 1.93-49.30).

CONCLUSION

ICI-induced colitis had an incidence rate of 3.5% and was associated with the combination of nivolumab and ipilimumab. Most patients with ICI-induced colitis developed mild symptoms that improved with supportive care alone, making ICI therapy resumption possible.

摘要

背景/目的:免疫检查点抑制剂(ICI)在癌症治疗中有效。然而,各种免疫相关不良事件(irAE)已变得普遍,其中ICI诱导的结肠炎是最常见的胃肠道irAE。因此,我们旨在调查韩国癌症患者中ICI诱导的结肠炎的发病率和危险因素。

方法

这项回顾性研究纳入了2015年10月至2022年6月在韩国大邱的两个三级转诊中心接受ICI治疗的患者。使用电子病历确定ICI诱导的结肠炎的发病率。通过单因素和多因素逻辑回归分析确定ICI诱导的结肠炎的危险因素。

结果

我们纳入了1478例接受ICI治疗的癌症患者。ICI诱导的结肠炎的发病率为3.5%(n = 52/1478)。多因素逻辑回归分析显示,纳武单抗和伊匹单抗联合使用是ICI诱导的结肠炎的一个危险因素(p = 0.006;比值比,9.768;95%置信区间,1.93 - 49.30)。

结论

ICI诱导的结肠炎发病率为3.5%,与纳武单抗和伊匹单抗联合使用有关。大多数ICI诱导的结肠炎患者出现轻度症状,仅通过支持治疗即可改善,使得恢复ICI治疗成为可能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c27/11725480/05900e4b1fb4/kjim-2024-135f1.jpg

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