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入住肿瘤内科医疗服务的成年实体瘤患者的免疫治疗相关不良事件和临床结局

Immunotherapy-Related Adverse Events and Clinical Outcomes in Adult Solid-Tumor Patients Admitted to an Onco-Hospitalist Medicine Service.

作者信息

Simbaqueba Clavijo Cesar, Odaro Orhue, Gandhi Ayush, Koom-Dadzie Kwame, Musaelyan Arine, Dickson Kodwo, Chua Rosalie, Bhise Viraj, Amoateng Magdelene, Tomy Sophy, Leal Alviarez Daniel, Phyu Ei Moe, Bogdanich Ivana, Andersen Clark, Sheshadri Ajay, Palaskas Nicolas L, Halm Josiah, Manzano Joanna

机构信息

Department of Hospital Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.

Pharmacy Clinical Programs, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.

出版信息

Cancers (Basel). 2025 Jan 25;17(3):403. doi: 10.3390/cancers17030403.

Abstract

: Few studies have focused on patients with immune-related adverse events (irAEs) after immune checkpoint inhibitor (ICI) treatment who were cared for primarily by hospitalists. The objective of our study was to describe the patterns and outcomes of adult solid-tumor cancer patients admitted to our onco-hospital medicine service. : We retrospectively reviewed patients with solid tumors who received ICIs and were admitted to our service in 2021-2022 with an irAE and compared them to a control group (IOTOX vs. NO IOTOX, respectively). The primary outcome was the patterns of irAEs requiring hospitalization; secondary outcomes included 30-day emergency room visit, readmission, and 30-day mortality. : There were 144 patients in the IOTOX group and 286 controls. The most common tumor type was lung and thoracic malignancies (62, 43.1%). The most common ICI causing the irAEs was pembrolizumab (66, 45.8%). The most common irAEs were pneumonitis (49, 34%), colitis (28, 19.4%), hepatitis (18, 12.5%), and myocarditis (16, 11.1%). Of the 144 patients, eight (6%) died from the hospitalization irAE. Fifteen (15.6%) had an ER visit within 30 days due to the same irAE, and thirteen (13.7%) were readmitted. Survival at 30 days after discharge did not differ significantly between groups. : Despite many patients having severe irAEs and irAEs associated with higher mortality, they generally had a favorable outcome compared to the literature.

摘要

很少有研究关注免疫检查点抑制剂(ICI)治疗后主要由住院医师护理的免疫相关不良事件(irAE)患者。我们研究的目的是描述入住我们肿瘤医院内科服务的成年实体瘤癌症患者的模式和结局。

我们回顾性分析了2021年至2022年期间接受ICI治疗并因irAE入住我们科室的实体瘤患者,并将他们与对照组(分别为IOTOX组和非IOTOX组)进行比较。主要结局是需要住院治疗的irAE模式;次要结局包括30天急诊就诊、再入院和30天死亡率。

IOTOX组有144例患者,对照组有286例。最常见的肿瘤类型是肺癌和胸部恶性肿瘤(62例,43.1%)。导致irAE最常见的ICI是帕博利珠单抗(66例,45.8%)。最常见的irAE是肺炎(49例,34%)、结肠炎(28例,19.4%)、肝炎(18例,12.5%)和心肌炎(16例,11.1%)。在这144例患者中,8例(6%)因住院期间的irAE死亡。15例(15.6%)因同一irAE在30天内就诊于急诊室,13例(13.7%)再次入院。出院后30天的生存率在两组之间没有显著差异。

尽管许多患者有严重的irAE且irAE与较高的死亡率相关,但与文献相比,他们的总体结局良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97e8/11816018/78e5dfd230e0/cancers-17-00403-g001.jpg

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