Clinical characteristics of immune checkpoint inhibitor-related pancreatic injury with pancreatitis in patients with advanced malignancies.

IF 4 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Digestive and Liver Disease Pub Date : 2025-03-27 DOI:10.1016/j.dld.2025.02.027

Takaya Suzuki, Kazuyuki Mizuno, Takafumi Yamamoto, Takanori Ito, Takuya Ishikawa, Takashi Honda, Shusuke Akamatsu, Makoto Ishii, Yuichi Ando, Hiroki Kawashima

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引用次数: 0

Abstract

Background/purpose: Immune checkpoint inhibitor (ICIs) therapy can cause immune checkpoint inhibitor-related pancreatic injury (ICI-PI). This study aimed to elucidate the clinical characteristics of ICI-PI and explore treatment approaches.

Methods: We retrospectively analyzed data from patients with malignancies treated with ICIs at Nagoya University Hospital between September 2014 and June 2023. ICI-PI and pancreatitis were identified and classified using the Common terminology Criteria for Adverse Events (CTCAE) ver.5.0, and the patients with ICI-PI with/without pancreatitis were analyzed.

Results: This study included data from 930 patients treated with ICIs. Of these, eight (0.85 %) and 10 (1.08 %) patients were diagnosed with ICI-PI without and with pancreatitis, respectively. Five of the 10 patients received standard pancreatitis treatment, while three received additional glucocorticoid therapy. One patient experienced recurrent pancreatitis and developed a pancreatic pseudocyst, which improved after high-dose glucocorticoid treatment. ICI rechallenge was pursued in five patients. Two patients received ICIs without an interval.

Conclusions: ICI-PI with pancreatitis is rare but has become more prevalent with the increasing use of ICIs. Future prospective multicenter studies are needed to confirm these findings and develop standardized diagnostic and treatment protocols.

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背景/目的：免疫检查点抑制剂（ICIs）治疗可导致免疫检查点抑制剂相关性胰腺损伤（ICI-PI）。本研究旨在阐明ICI-PI的临床特征并探索治疗方法：我们回顾性分析了2014年9月至2023年6月期间名古屋大学医院使用ICIs治疗的恶性肿瘤患者的数据。采用不良事件通用术语标准（CTCAE）ver.5.0对ICI-PI和胰腺炎进行识别和分类，并对伴有/不伴有胰腺炎的ICI-PI患者进行分析：该研究包括930名接受ICI治疗的患者的数据。其中，8 例（0.85%）和 10 例（1.08%）患者分别被诊断为无胰腺炎和有胰腺炎的 ICI-PI。10 名患者中有 5 人接受了标准的胰腺炎治疗，3 人接受了额外的糖皮质激素治疗。一名患者胰腺炎复发并出现胰腺假性囊肿，经大剂量糖皮质激素治疗后好转。五名患者接受了 ICI 重试。两名患者接受了无间隔 ICI 治疗：结论：ICI-PI 并发胰腺炎并不多见，但随着 ICIs 使用量的增加，其发病率也越来越高。未来需要进行前瞻性多中心研究，以证实这些发现并制定标准化的诊断和治疗方案。

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

Digestive and Liver Disease 医学-胃肠肝病学

CiteScore

6.10

自引率

2.20%

发文量

632

审稿时长

19 days

期刊介绍： Digestive and Liver Disease is an international journal of Gastroenterology and Hepatology. It is the official journal of Italian Association for the Study of the Liver (AISF); Italian Association for the Study of the Pancreas (AISP); Italian Association for Digestive Endoscopy (SIED); Italian Association for Hospital Gastroenterologists and Digestive Endoscopists (AIGO); Italian Society of Gastroenterology (SIGE); Italian Society of Pediatric Gastroenterology and Hepatology (SIGENP) and Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD). Digestive and Liver Disease publishes papers on basic and clinical research in the field of gastroenterology and hepatology. Contributions consist of: Original Papers Correspondence to the Editor Editorials, Reviews and Special Articles Progress Reports Image of the Month Congress Proceedings Symposia and Mini-symposia.