Comparison of immune-related adverse events and analysis of risk factors in older and younger rectal cancer patients receiving immunotherapy.

IF 3.6 3区医学 Q2 ONCOLOGY

American journal of cancer research Pub Date : 2025-05-15 eCollection Date: 2025-01-01 DOI:10.62347/QLFX5040

Jie Liao, Haiwen Ye, Jian Wang, Fei Liu, Hongjia Zhu, Guowei Xie, Junjiang Pan

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引用次数: 0

Abstract

Background: Immunotherapy has transformed rectal cancer treatment but poses risks of immune-related adverse events (irAEs), particularly in elderly patients who exhibit immunosenescence and inflammaging. This study compares the incidence and severity of irAEs in elderly and young rectal cancer patients receiving immunotherapy and identifies predictive biomarkers for these events.

Methods: We retrospectively analyzed 405 rectal cancer patients treated with immunotherapy from January 2015 to December 2023. Patients were categorized into younger (< 60 years) and older (≥ 60 years) groups. Incidence and severity of irAEs were assessed using the Common Terminology Criteria for Adverse Events (CTCAE) standards. Blood samples were analyzed for hematological and immunological markers.

Results: The older group displayed a significantly higher incidence of irAEs at 48.65% compared to 32.11% in the younger group (P = 0.003). Severity varied, with 69.72% of younger patients experiencing irAEs of grade ≤ 2 versus 51.69% in the older group (P = 0.001). Notably, higher absolute lymphocyte count (ALC), interleukin-6 (IL-6), and C-reactive protein (CRP) levels were associated with increased irAEs (P = 0.002, P = 0.001, P = 0.007, respectively). The multivariate analysis identified ALC, IL-6, CRP, B and T Lymphocyte Attenuator, Human Granulocyte-macrophage Colony Stimulating Factor, Programmed Death-1 and Programmed Death-Ligand 1 as significant predictors of irAEs, with ALC showing an odds ratio (OR) of 9.700 (P = 0.001) and IL-6 an OR of 58.961 (P < 0.001). Furthermore, the platelet-to-lymphocyte ratio (PLR) inversely correlated with irAEs (P = 0.013).

Conclusion: Older rectal cancer patients receiving immunotherapy were at increased risk for both greater incidence and severity of irAEs. Specific biomarkers, such as ALC and IL-6, were associated with a heightened risk of these events.

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接受免疫治疗的老年和年轻直肠癌患者免疫相关不良事件的比较及危险因素分析。

背景：免疫疗法已经改变了直肠癌的治疗方式，但存在免疫相关不良事件（irAEs）的风险，特别是在表现出免疫衰老和炎症的老年患者中。本研究比较了接受免疫治疗的老年和年轻直肠癌患者的irae发生率和严重程度，并确定了这些事件的预测性生物标志物。方法：回顾性分析2015年1月至2023年12月接受免疫治疗的405例直肠癌患者。患者分为年轻组（< 60岁）和老年组（≥60岁）。使用不良事件通用术语标准（CTCAE）标准评估irae的发生率和严重程度。对血样进行血液学和免疫学指标分析。结果：老年组irAEs发生率为48.65%，明显高于年轻组32.11% （P = 0.003）。严重程度各不相同，69.72%的年轻患者经历≤2级的irae，而老年组为51.69% （P = 0.001）。值得注意的是，较高的绝对淋巴细胞计数（ALC）、白细胞介素-6 （IL-6）和c反应蛋白（CRP）水平与irAEs升高相关（P = 0.002、P = 0.001和P = 0.007）。多因素分析发现，ALC、IL-6、CRP、B和T淋巴细胞衰减剂、人粒细胞-巨噬细胞集落刺激因子、程序性死亡-1和程序性死亡-配体1是irAEs的显著预测因子，其中ALC的比值比（OR）为9.700 (P = 0.001)， IL-6的比值比（OR）为58.961 （P < 0.001）。此外，血小板与淋巴细胞比率（PLR）与irAEs呈负相关（P = 0.013）。结论：接受免疫治疗的老年直肠癌患者irAEs的发生率和严重程度均有增加的风险。特定的生物标志物，如ALC和IL-6，与这些事件的高风险相关。

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

American journal of cancer research ONCOLOGY-

自引率

3.80%

发文量

263

期刊介绍： The American Journal of Cancer Research (AJCR) (ISSN 2156-6976), is an independent open access, online only journal to facilitate rapid dissemination of novel discoveries in basic science and treatment of cancer. It was founded by a group of scientists for cancer research and clinical academic oncologists from around the world, who are devoted to the promotion and advancement of our understanding of the cancer and its treatment. The scope of AJCR is intended to encompass that of multi-disciplinary researchers from any scientific discipline where the primary focus of the research is to increase and integrate knowledge about etiology and molecular mechanisms of carcinogenesis with the ultimate aim of advancing the cure and prevention of this increasingly devastating disease. To achieve these aims AJCR will publish review articles, original articles and new techniques in cancer research and therapy. It will also publish hypothesis, case reports and letter to the editor. Unlike most other open access online journals, AJCR will keep most of the traditional features of paper print that we are all familiar with, such as continuous volume, issue numbers, as well as continuous page numbers to retain our comfortable familiarity towards an academic journal.