Jung Jiyun, Park Seong Yeon, Jo Hee Bum, Park Jae Yoon, Kim Dalyong, Lee Kyoungmin, Choi Sungim
Department of Biostatistics, Dongguk University College of Medicine, Goyang-si, Gyeonggi-do, Republic of Korea.
Division of Infectious Diseases, Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea.
Discov Oncol. 2025 May 30;16(1):950. doi: 10.1007/s12672-025-02627-8.
This study determined the incidence of Pneumocystis jirovecii pneumonia (PCP) in patients with lung cancer based on immune checkpoint inhibitor (ICI) exposure.
National claims data were obtained from 68,174 patients with lung cancer treated with ICIs or comparator non-ICIs (cytotoxic chemotherapy, targeted therapy, or both) between August 2017 and December 2021 in South Korea. The ICI exposure group included patients who were treated with ICIs at least once during the study period. The incidence and standardized incidence ratios were computed according to sex, 10-year age, and calendar-specific cancer population, to estimate the effects of ICIs and non-ICIs on the incidence of PCP. A logistic regression analysis was performed that adjusted for sex, age, comorbidities, and concomitant immunosuppressive drugs use.
A total of 18,043 (26.4%) patients were in the ICI exposure group, and 50,131 (73.6%) were in the ICI non-exposure group. More than half of the patients in the ICI exposure group were men aged 60-79 years. Twenty-one PCP events occurred every 42,000.39 person-years in the ICI exposure group, and the incidence of PCP was lower than that in the ICI non-exposure group. Compared to the total cancer population, the incidence of PCP in patients with lung cancer was not significantly affected by ICI exposure, sex, or age. A 36% decreased risk of PCP with ICI exposure compared with non-exposure was estimated; however, this result was not statistically significant.
The incidence of PCP in patients with lung cancer treated with ICIs did not differ significantly from that in patients not treated with ICIs.
本研究基于免疫检查点抑制剂（ICI）暴露情况，确定肺癌患者中耶氏肺孢子菌肺炎（PCP）的发病率。
获取了2017年8月至2021年12月期间在韩国接受ICI或对照非ICI（细胞毒性化疗、靶向治疗或两者皆用）治疗的68174例肺癌患者的全国索赔数据。ICI暴露组包括在研究期间至少接受过一次ICI治疗的患者。根据性别、10岁年龄组和特定日历年份的癌症人群计算发病率和标准化发病率，以评估ICI和非ICI对PCP发病率的影响。进行了逻辑回归分析，对性别、年龄、合并症和同时使用免疫抑制药物进行了校正。
ICI暴露组共有18043例（26.4%）患者，ICI非暴露组有50131例（73.6%）患者。ICI暴露组中超过一半的患者为60 - 79岁男性。ICI暴露组每42000.39人年发生21例PCP事件，PCP发病率低于ICI非暴露组。与全部癌症人群相比，肺癌患者的PCP发病率不受ICI暴露、性别或年龄的显著影响。估计ICI暴露组与非暴露组相比，PCP风险降低36%；然而，这一结果无统计学意义。
接受ICI治疗的肺癌患者中PCP的发病率与未接受ICI治疗的患者相比无显著差异。
