Mengni Guo, Jieying Liu, Ruoyu Miao, Zohaib Ahmed, James Yu, Jian Guan, Sarfraz Ahmad, Shuntai Zhou, Angela Grove, Manoucher Manoucheri, Mark A Socinski, Tarek Mekhail
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引用次数: 3
摘要
免疫检查点抑制剂(ICIs)可引起多种免疫相关不良事件(irAEs)。2019冠状病毒病(COVID-19)与促炎细胞因子的增加有关,这可能会影响irae的结果。关于COVID-19对ci治疗的癌症患者的irae影响的数据有限。因此,在本研究中,我们回顾性分析了2020年8月至2021年8月在同一家机构接受ici治疗的成年恶性实体瘤患者。在COVID-19检测阳性之前或之后1个月内接受过最近一次ICI治疗的患者被排除在研究之外。对于COVID-19阳性组,仅将COVID-19感染后发生的irae视为事件。我们共纳入579例患者,其中COVID-19阳性组46例(7.9%),阴性组533例(92.1%)。两组患者的基线特征相似。中位随访331天(范围:21-2226),我们注意到COVID-19阳性组的所有级别irae发生率均无显著性升高(30.4% vs. 19.9%, P =0.18)。COVID-19阳性组3级和4级irae发生率显著高于对照组(10.9% vs. 3.2%, P =0.02)。多因素分析证实COVID-19感染与严重irAE发展风险增加之间存在关联(优势比:1.08,95%可信区间:1.02-1.14,P =0.01)。我们的研究表明,COVID-19可能会对接受ici的癌症患者造成严重的irae风险。当癌症患者感染COVID-19时,可以考虑密切监测,并可能推迟ICI的使用。
A Single Center Retrospective Study of the Impact of COVID-19 Infection on Immune-related Adverse Events in Cancer Patients Receiving Immune Checkpoint Inhibitors.
Immune checkpoint inhibitors (ICIs) can cause a variety of immune-related adverse events (irAEs). The coronavirus disease 2019 (COVID-19) is associated with increased amounts of pro-inflammatory cytokines, which may affect the outcome of irAEs. Data are limited regarding the impact of COVID-19 on irAEs in ICI-treated cancer patients. Hence, in this study, we retrospectively analyzed ICI-treated adult patients with malignant solid tumors at a single institution between August 2020 and August 2021. Patients who had the most recent ICI treatment over 1-month before or after the positive COVID-19 test were excluded from the study. For the COVID-19 positive group, only the irAEs that developed after COVID-19 infection were considered as events. A total of 579 patients were included in our study, with 46 (7.9%) in the COVID-19 positive group and 533 (92.1%) in the COVID-19 negative group. The baseline characteristics of patients in the 2 groups were similar. With a median follow-up of 331 days (range: 21-2226), we noticed a nonsignificant higher incidence of all-grade irAEs in the COVID-19 positive group (30.4% vs. 19.9%, P =0.18). The incidence of grade 3 and 4 irAEs was significantly higher in the COVID-19 positive group (10.9% vs. 3.2%, P =0.02). Multivariate analysis confirmed the association between COVID-19 infection and increased risk of severe irAE development (odds ratio: 1.08, 95% confidence interval: 1.02-1.14, P =0.01). Our study suggested that COVID-19 may pose a risk of severe irAEs in cancer patients receiving ICIs. Close monitoring and possibly delaying ICI administration could be considered when cancer patients are infected with COVID-19.
期刊介绍:
Journal of Immunotherapy features rapid publication of articles on immunomodulators, lymphokines, antibodies, cells, and cell products in cancer biology and therapy. Laboratory and preclinical studies, as well as investigative clinical reports, are presented. The journal emphasizes basic mechanisms and methods for the rapid transfer of technology from the laboratory to the clinic. JIT contains full-length articles, review articles, and short communications.