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癌症患者免疫相关严重不良事件的相关危险因素:一项范围综述。

Risk factors associated with immune-related severe adverse events in patients with cancer: A scoping review.

作者信息

Su Zhenzhen, Zhang Liyan, Lian Xuemin, Wang Yixuan

机构信息

School of Nursing, Peking University, Beijing, China.

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Oncology, Peking University Cancer Hospital & Institute, Beijing, China.

出版信息

Asia Pac J Oncol Nurs. 2025 Feb 7;12:100661. doi: 10.1016/j.apjon.2025.100661. eCollection 2025 Dec.

Abstract

OBJECTIVE

Increasing reports of immune-related severe adverse events (ir-SAEs) among patients with cancer treated with immune checkpoint inhibitors (ICIs) have raised significant concerns regarding patient safety. Although considerable research has addressed immune-related adverse events (irAEs), the risk factors specifically associated with ir-SAEs remain less well defined. This study aims to identify and synthesize the risk factors contributing to ir-SAEs in patients with cancer.

METHODS

Adhering to the Joanna Briggs Institute scoping review guidelines, we conducted a comprehensive literature search across multiple databases including PubMed, Embase, Web of Science, ProQuest Dissertations and Theses, Clinical Trials, China Biomedical Literature Database, CNKI, Wanfang Database, and VIP Database. Studies published from the inception of each database up to 28 January 2024 were considered. Two independent reviewers screened the literature and extracted the relevant data.

RESULTS

A total of 41 studies were included, comprising 20 retrospective case-control studies, 9 retrospective cohort studies, 8 prospective cohort studies, and 4 meta-analyses. The analysis identified three primary categories of risk factors: demographic factors, disease-related factors, and laboratory examination-related factors.

CONCLUSIONS

A diverse range of risk factors is associated with ir-SAEs in patients with cancer. Enhancing the education of clinical oncology nurses regarding these risk factors may facilitate early identification and management of high-risk groups, thereby improving patient safety. Given the observed inconsistencies among studies, further research is warranted to elucidate risk factors with high predictive value for ir-SAEs.

摘要

目的

接受免疫检查点抑制剂(ICI)治疗的癌症患者中,免疫相关严重不良事件(ir-SAE)的报告日益增多,这引发了对患者安全的重大担忧。尽管已有大量研究探讨了免疫相关不良事件(irAE),但与ir-SAE具体相关的危险因素仍不太明确。本研究旨在识别并综合分析导致癌症患者发生ir-SAE的危险因素。

方法

遵循乔安娜·布里格斯研究所的范围综述指南,我们在多个数据库中进行了全面的文献检索,包括PubMed、Embase、科学网、ProQuest学位论文数据库、临床试验数据库、中国生物医学文献数据库、中国知网、万方数据库和维普数据库。考虑了从每个数据库建立之初到2024年1月28日发表的研究。两名独立评审员筛选文献并提取相关数据。

结果

共纳入41项研究,包括20项回顾性病例对照研究、9项回顾性队列研究、8项前瞻性队列研究和4项荟萃分析。分析确定了三类主要危险因素:人口统计学因素、疾病相关因素和实验室检查相关因素。

结论

癌症患者的ir-SAE与多种危险因素相关。加强临床肿瘤学护士对这些危险因素的教育,可能有助于早期识别和管理高危人群,从而提高患者安全性。鉴于研究中观察到的不一致性,有必要进一步研究以阐明对ir-SAE具有高预测价值的危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4cf4/11889633/edf3acf63e8b/gr1.jpg

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