Retrospective analysis of clinical features of nivolumab-induced immune-related pancreatitis.

IF 3 3区 医学 Q2 ONCOLOGY
Investigational New Drugs Pub Date : 2025-04-01 Epub Date: 2025-02-24 DOI:10.1007/s10637-025-01517-8
Yong Pan, Wei Li, Zhaoquan Wu, Wei Sun, Binsheng He, Chunjiang Wang
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Abstract

To study the clinical features of nivolumab-induced immune-related pancreatitis and to provide evidence for its recognition and treatment. Cases of nivolumab-induced pancreatitis were collected by searching Chinese and English databases until November 30, 2024. Forty-three patients were included, with a median age of 61 years (range 23, 79). The median time to onset of pancreatitis was 120 days (range 1, 990) after initial administration. The main symptoms of the patients were abdominal pain (55.8%), nausea (14.0%), vomiting (11.6%), fever (9.3%), anorexia (9.3%), and asymptomatic (7.0%). Laboratory tests showed elevated lipase and amylase levels, with median values of 391.5 IU/L (range 136, 4050) and 1588 IU/L (range 248, 8788), respectively. Pancreatic biopsy showed inflammatory cell infiltration (18.6%), fibrosis (7.0%), and acinar damage and dropout (4.7%). The main imaging findings were focal or diffuse enlargement of the pancreas and fat stranding. After discontinuation of nivolumab and receiving steroid and immunosuppressive therapy (88.4%), patients' symptoms improved at a median time of 42 days (range 7, 192), and 11.6% of patients died. Immune-related pancreatitis should be alert during nivolumab administration. The lack of specificity of clinical symptoms and laboratory tests confuses the diagnosis of pancreatitis. The diagnosis of immune-associated pancreatitis should be treated promptly.

尼伏单抗诱导的免疫相关性胰腺炎临床特征的回顾性分析。
目的:探讨尼伏单抗诱发的免疫相关性胰腺炎的临床特点,为其识别和治疗提供依据。通过检索中英文数据库收集尼伏单抗诱发性胰腺炎病例,截止到2024年11月30日。纳入43例患者,中位年龄61岁(范围23,79)。初始给药后至胰腺炎发病的中位时间为120天(范围1990)。主要症状为腹痛(55.8%)、恶心(14.0%)、呕吐(11.6%)、发热(9.3%)、厌食(9.3%)、无症状(7.0%)。实验室检测显示脂肪酶和淀粉酶水平升高,中位值分别为391.5 IU/L(范围136 - 4050)和1588 IU/L(范围248 - 8788)。胰腺活检显示炎症细胞浸润(18.6%),纤维化(7.0%),腺泡损伤和脱落(4.7%)。主要影像学表现为胰腺局灶性或弥漫性肿大和脂肪搁浅。停用纳武单抗并接受类固醇和免疫抑制治疗(88.4%)后,患者的症状在中位42天(范围7,192)内得到改善,11.6%的患者死亡。在纳武单抗给药期间应警惕免疫相关性胰腺炎。缺乏特异性的临床症状和实验室检查混淆了胰腺炎的诊断。诊断为免疫相关性胰腺炎应及时治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.60
自引率
0.00%
发文量
121
审稿时长
1 months
期刊介绍: The development of new anticancer agents is one of the most rapidly changing aspects of cancer research. Investigational New Drugs provides a forum for the rapid dissemination of information on new anticancer agents. The papers published are of interest to the medical chemist, toxicologist, pharmacist, pharmacologist, biostatistician and clinical oncologist. Investigational New Drugs provides the fastest possible publication of new discoveries and results for the whole community of scientists developing anticancer agents.
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