非小细胞肺癌患者经帕博利珠单抗治疗后发生内分泌毒性的影响因素研究  

The influencing factors of endocrine toxicity in patients with non-small cell lung cancer after treatment with pembrolizumab

作　　者：高庆龄 苏丹 张桂芳[3] GAO Qing-ling;SU Dan;ZHANG Gui-fang(The Fourth Clinical College of Xinxiang Medical College,Xinxiang 453000,China;不详)

机构地区：[1]新乡医学院第四临床学院,河南新乡453000 [2]泽州县人民医院肿瘤内科,山西晋城048000 [3]新乡市中心医院肿瘤内科,河南新乡453000

出　　处：《中国处方药》2024年第3期97-99,共3页Journal of China Prescription Drug

摘　　要：目的探讨帕博利珠单抗治疗非小细胞肺癌(non-small cell lung cancer,NSCLC)患者后发生内分泌毒性的影响因素。方法选择2020年1月1日~2022年12月31日期间于晋城市第二人民医院住院,并接受过至少1个疗程帕博利珠单抗治疗的原发性NSCLC的连续病例作为研究对象,收集患者临床资料,以是否发生帕博利珠单抗相关内分泌毒性的患者进行分组,发生内分泌毒性的作为病例组,以未发生内分泌毒性的患者作为对照组,采用单因素和多因素Logistic回归分析评估帕博利珠单抗治疗NSCLC患者后发生内分泌毒性的危险因素。结果本研究共纳入了153例,其中72例(47.06%)出现不同级别的内分泌毒性,单因素分析结果显示两组在年龄、治疗前PD-L1表达、疗程、化疗、靶向药物治疗、化疗+靶向药物方面有显著差异(P<0.05)。多因素Logistic回归分析显示,疗程、治疗前PD-L1低表达、靶向药物、化疗及化疗+靶向药物是发生帕博利珠单抗内分泌毒性的危险因素。结论患者疗程、治疗前PD-L1低表达、靶向药物、化疗及化疗+靶向药物是NSCLC患者接受帕博利珠单抗治疗后发生内分泌毒性的危险因素。Objective To investigate the influencing factors of endocrine toxicity in patients with non-small cell lung cancer(NSCLC)treated with pabolizumab.Methods Continuous cases of primary NSCLC hospitalized in the Second People's Hospital of Jincheng City from January 1,2020 to December 31,2022 who had received at least one course of pembrolizumab treatment were selected as the study objects.General data were collected.Patients with or without pembrolizumab related endocrine toxicity were divided into two groups,patients with endocrine toxicity as the case group,and patients without endocrine toxicity as the control group.Univariate analysis and multivariate Logistic regression analysis were used to determine the risk factors for endocrine toxicity after pembrolizumab treatment.Results A total of 153 cases were included in this study,of which 72 cases(47.06%)showed different levels of endocrine toxicity.Univariate analysis showed that there were significant differences between the case group and the control group in age,PD-L1 expression before treatment,duration of treatment,chemotherapy,targeted drugs,chemotherapy+targeted drugs(P<0.05).Multivariate Logistic regression analysis showed that duration of treatment,low PD-L1 before treatment,targeted drugs,chemotherapy and chemotherapy+targeted drugs were risk factors for endocrine toxicity of pembrolizumab.Conclusion Duration of treatment,low PD-L1 level before treatment,targeted drugs,chemotherapy and chemotherapy+targeted drugs are the influencing factors for endocrine toxicity of pembrolizumab.

关 键 词：非小细胞肺癌 帕博利珠单抗 内分泌毒性 影响因素 

分 类 号：R734.2[医药卫生—肿瘤] R969[医药卫生—临床医学]