替雷利珠单抗治疗非小细胞肺癌免疫相关不良事件分析  

Analysis of immune-related adverse events after treatment with trelizumab in patients with non-small cell lung cancer

作　　者：胡敏 刘文侠[1] 李劲松[2] Hu Min;Liu Wen-xia;Li Jing-song(Department of Pharmacy,Xuzhou Central Hospital,Xuzhou 221009,China;Department of Oncology,Xuzhou Central Hospital,Xuzhou 221009,China)

机构地区：[1]徐州市中心医院药剂科,徐州221009 [2]徐州市中心医院肿瘤科,徐州221009

出　　处：《中国药物应用与监测》2024年第4期368-371,共4页Chinese Journal of Drug Application and Monitoring

摘　　要：目的 探讨替雷利珠单抗治疗非小细胞肺癌(NSCLC)患者时出现免疫相关不良事件(ir AEs)频率及特点。方法 回顾分析徐州市中心医院2022年6月至2023年12月接受替雷利珠单抗进行治疗的114例NSCLC患者的病历资料,根据其用药方式分为单独用药组42例(替雷利珠单抗)、联合用药组72例(替雷利珠联合血管抑制药物或靶向治疗药物),对两组患者出现ir AEs进行分析。结果 单独用药组中16例(38.10%)患者出现ir AEs,共发生53例次ir AEs,其中最常出现的是皮疹、输液反应、免疫相关性腹泻。联合用药组中43例(59.72%)患者出现ir AEs,共发生192例次ir AEs,其中最常出现的是皮疹、输液反应、免疫相关性腹泻以及食欲减退。单独用药组在免疫性肝损害、免疫相关性关节炎、肺部感染、皮疹、瘙痒、输液反应以及食欲减退等ir AEs发生率低于联合用药组,差异有统计学意义(t=4.11、4.038、6.050、4.283、5.348、4.361、4.343,均P<0.05)。结论 替雷利珠单抗作为治疗NSCLC患者药物时单独用药出现ir AEs的频率低于联合用药,不良反应总体可控,但若不采取相应的干预措施以及治疗措施可能会对患者造成严重损伤甚至威胁生命。Objective To investigate the frequency and characteristics of immune-related adverse events(irAEs)following treatment with trelizumab in patients with non-small cell lung cancer(NSCLC).Methods A retrospective analysis was conducted on clinical data of 114 NSCLC patients receiving treatment with trelizumab in Xuzhou Central Hospital from June 2022 to December 2023.The patients were divided into a monotherapy group of 42 cases(trelizumab)and a combination group of 72 cases(trelizumab combined with vasodilators or targeted therapy drugs)based on their medication regimen.irAEs were analyzed in both groups.Results Sixteen of the 42 patients(38.10%)in the monotherapy group developed a total of 53 irAEs presented by frequent occurrence of rash,infusion reactions and immune-related diarrhea.Forty-three of the 72 patients(59.72%)in the combination group developed a total of 192 irAEs presented by frequent appearance of rash,infusion reactions,immune-related diarrhea and loss of appetite.The incidence of irAEs such as immunological liver injury,immune-related arthritis,pulmonary infections,rash,pruritus,infusion reactions and loss of appetite was significantly lower in the monotherapy group than in the combination group(t=4.11,4.038,6.050,4.283,5.348,4.361 and 4.343,all P<0.05).Conclusion The frequency of irAEs in patients with NSCLC receiving trelizumab monotherapy is less than that in those undergoing combination therapy.These irAEs are generally controllable.However,the patients may experience serious injuries or even life-threatening injuries without appropriate interventions as well as therapeutic measures.

关 键 词：替雷利珠单抗 非小细胞肺癌 免疫相关不良事件 免疫检查点抑制剂 免疫治疗 

分 类 号：R979.1[医药卫生—药品]