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Received:September 25, 2021 Published Online:May 20, 2022
Received:September 25, 2021 Published Online:May 20, 2022
中文摘要: 目的 观察晚期恶性肿瘤患者免疫检查点抑制剂(ICIs)治疗中免疫相关不良反应(irAEs)的发生情况,以期提高对irAEs的诊治水平。方法 回顾性分析2019年1月至2021年5月在安徽医科大学第三附属医院进行ICIs(信迪利单抗)治疗的80例晚期恶性肿瘤患者,观察治疗期间患者发生的irAEs,包括不良反应的种类、分级、发生时间、处理措施、预后等。结果 80例患者中,32例患者发生irAEs,总体发生率40.0%,不良反应中位发生时间4.857周,其中14例免疫性输注反应,7例免疫性皮炎,5例免疫性甲状腺功能异常,5例免疫性胃肠道毒性,1例免疫性肺炎;1、2级不良反应发生率为96.9%;31例患者经对症治疗、激素冲击治疗和维持治疗后不良反应完全缓解,1例患者因免疫性肺炎死亡。结论 irAEs发生率较高,大部分为1、2级不良反应,总体安全性较高,不良反应可耐受。
Abstract:ObjectiveTo observe the immune related adverse reactions caused by immune checkpoint inhibitors in 80 patients with advanced malignant tumors. Methods Retrospective analysis was performed on 80 patients with advanced malignant tumor who received immune checkpoint inhibitor treatment in the Third Affiliated Hospital of Anhui Medical University from January 2019 to May 2021. The immune related adverse reactions during the treatment period were observed, including the type, grade, occurrence time, treatment measures and prognosis of adverse reactions. Results Among the 80 patients, 32 patients developed immune treatment-related adverse reactions, with an overall incidence of 40.0% and a median occurrence time of 4.857 weeks, including 14 cases of immunological infusion reaction, 7 cases of immunological dermatitis, 5 cases of immunological thyroid dysfunction, 5 cases of immunological gastrointestinal toxicity and 1 case of immunological pneumonia. The grade 1 or 2 adverse reactions incidence of 96.9%. After symptomatic treatment, hormone shock therapy and maintenance therapy, 31 patients had complete remission of adverse reactions, and 1 patient died of immune pneumonia. Conclusion The incidence of immune-related adverse reactions is high, most of which are grade 1 or 2 adverse reactions. The overall safety is high and the adverse reactions can be tolerated.
keywords: Immune checkpoint inhibitors Sintilimab Immune-related adverse reactions Immunotherapy Malignant tumors, advanced
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