接受免疫检查点抑制剂治疗伴与不伴炎症性肠病患者的腔免疫相关不良事件
Oral immune-related adverse events in patients with and without inflammatory bowel disease receiving immune checkpoint inhibitor therapy.
文献信息
| PMID | 42970638 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Sharada Wali |
| 作者单位 | Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer CenterHouston, TX 77030, United States. |
| 期刊 | Inflammatory bowel diseases |
| SCI 分区 | Q1 |
| IF | 5.7 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景： 免疫检查点抑制剂（ICIs）与腔免疫相关不良事件（irAEs）相关。我们试图确定炎症性肠病（IBD）中的黏膜免疫失调是否使患者易患这些毒性效应的更高风险或更严重程度。
方法： 这项回顾性队列研究评估了2012年至2024年间在一家三级癌症中心接受ICIs治疗的成年癌症患者。在开始ICIs后1年内发生腔irAEs的患者按IBD状态分层；IBD患者根据年龄、性别和癌症类型与非IBD患者按1:2匹配。我们从电子健康记录中检索临床信息。
结果： 在接受ICIs治疗的450名患者中，152名患有既往IBD。IBD患者至腔病变发作的中位时间更长。腔黏膜毒性效应显著较少见，口干症、味觉障碍、黏膜炎、吞咽困难和腔念珠菌病等症状在IBD患者中均显著较低。黏膜炎、腔疼痛和吞咽困难的严重程度分级在两组间相似。IBD组较少使用针对腔irAEs的支持性护理。因腔病变导致的住院罕见，两组间ICI治疗暂停的比例相似。IBD患者腔病变复发较少见。
结论： 接受ICIs的IBD患者比无IBD者更不可能发生腔irAEs，可能是由于在ICI治疗前或期间开始的同期IBD治疗的保护作用。这些结果突出了ICI治疗在IBD患者中的可行性和耐受性。
英文摘要
BACKGROUND: Immune checkpoint inhibitors (ICIs) are associated with oral immune-related adverse events (irAEs). We sought to determine whether mucosal immune dysregulation in inflammatory bowel disease (IBD) predisposes patients to a higher risk or severity of these toxic effects.
METHODS: This retrospective cohort study evaluated adult cancer patients treated with ICIs at a tertiary cancer center between 2012 and 2024. Patients who developed oral irAEs within 1 year of starting ICIs were stratified by IBD status; IBD patients were matched 1:2 with non-IBD patients based on age, sex, and cancer type. We retrieved clinical information from electronic health records.
RESULTS: Of 450 patients treated with ICIs, 152 had pre-existing IBD. Patients with IBD had a longer median time to oral lesion onset. Oral mucosal toxic effects were significantly less frequent, and symptoms such as xerostomia, dysgeusia, mucositis, dysphagia, and oral candidiasis were all significantly lower in IBD patients. Severity grades for mucositis, oral pain, and dysphagia were similar between groups. Supportive care for oral irAEs was used less often in the IBD group. Hospitalizations due to oral lesions were rare, and ICI therapy was paused in similar proportions between groups. Recurrence of oral lesions was less frequent in IBD patients.
CONCLUSION: Patients with IBD who receive ICIs were less likely to develop oral irAEs than those without IBD, possibly due to the protective effects of concurrent IBD therapies initiated before or during ICI treatment. These results highlight the feasibility and tolerability of ICI therapy in patients with IBD.