Are patients with chronic obstructive pulmonary disease at a greater risk for the development of autoimmune thyroiditis as an adverse event of immunotherapy in non-small cell lung cancer treatment?
Andrej Zecevic, Ana Blanka-Protic, Aleksandar Jandric, Tatjana Adzic-Vukicevic
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引用次数: 0
Abstract
Introduction: Immunotherapy has made a significant improvement in the treatment of patients with non-small cell lung cancer (NSCLC). It has a role in boosting the immune system, so it can fight cancer cells. Sometimes, this mechanism can lead to an overstimulation or misdirection of immune response, so it can act against the body itself. One of the organs most affected by this reaction is the thyroid gland, and there is no definitive explanation of the causes of this adverse event.
Material and methods: In this retrospective observational study, we enrolled 103 patients with NSCLC and high PD-L1 expression (>= 50%) who were treated in our Clinic for pulmonology, University Clinical Center of Serbia, using Pembrolizumab as the first-line therapy.
Results: Data analysis showed that 41 (39.81%) of 103 patients in our study had an adverse event of immunotherapy, and 21 of them had autoimmune thyroiditis (20.39%). Of all the patients, 19 of them were treated for chronic obstructive pulmonary disease (COPD) before the onset of Pembrolizumab. During treatment, eight of these patients developed thyroid dysfunction. Patients with COPD were at increased risk of developing autoimmune thyroiditis compared to non-COPD patients (OR 3.9 95% CI 1.135-13.260, p = 0.0227).
Conclusion: Our study showed that patients dealing with COPD have a 3.9 times greater risk of developing autoimmune thyroiditis as an adverse event during Pembrolizumab treatment compared with patients without COPD.
免疫疗法在非小细胞肺癌(NSCLC)患者的治疗中取得了显著的进步。它有增强免疫系统的作用,所以它可以对抗癌细胞。有时,这种机制会导致过度刺激或误导免疫反应,因此它可以对身体本身起作用。受这种反应影响最大的器官之一是甲状腺,对这种不良事件的原因没有明确的解释。材料和方法:在这项回顾性观察性研究中,我们招募了103例非小细胞肺癌和高PD-L1表达(>= 50%)的患者,这些患者在我们塞尔维亚大学临床中心的肺科诊所接受了派姆单抗作为一线治疗。结果:本研究103例患者中有41例(39.81%)发生免疫治疗不良事件,其中21例发生自身免疫性甲状腺炎(20.39%)。在所有患者中,有19人在使用派姆单抗前接受过慢性阻塞性肺疾病(COPD)的治疗。在治疗期间,其中8名患者出现甲状腺功能障碍。与非COPD患者相比,COPD患者发生自身免疫性甲状腺炎的风险增加(OR 3.9 95% CI 1.135-13.260, p = 0.0227)。结论:我们的研究表明,COPD患者在Pembrolizumab治疗期间发生自身免疫性甲状腺炎的不良事件的风险是无COPD患者的3.9倍。
期刊介绍:
Pathology & Oncology Research (POR) is an interdisciplinary Journal at the interface of pathology and oncology including the preclinical and translational research, diagnostics and therapy. Furthermore, POR is an international forum for the rapid communication of reviews, original research, critical and topical reports with excellence and novelty. Published quarterly, POR is dedicated to keeping scientists informed of developments on the selected biomedical fields bridging the gap between basic research and clinical medicine. It is a special aim for POR to promote pathological and oncological publishing activity of colleagues in the Central and East European region. The journal will be of interest to pathologists, and a broad range of experimental and clinical oncologists, and related experts. POR is supported by an acknowledged international advisory board and the Arányi Fundation for modern pathology.