Blood:免疫检查点抑制剂治疗的癌症患者的血栓栓塞风险增加!

2020-10-19 星云 MedSci原创

目前,与免疫检查点抑制剂相关的静脉和动脉血栓栓塞(VTE/ATE)的风险尚未完全明确,在癌症患者中评估这类药物的临床试验并未提供相关信息。

中心点:

采用免疫检查点抑制剂治疗的癌症患者具有较高的发生静脉和动脉血栓栓塞的风险。

免疫检查点抑制剂作用下的静脉血栓栓塞严重影响临床预后,并且难以预测。

摘要:

目前,与免疫检查点抑制剂相关的静脉和动脉血栓栓塞(VTE/ATE)的风险尚未完全明确,在癌症患者中评估这类药物的临床试验并未提供相关信息。

该研究目的是量化接受免疫检查点抑制剂治疗的一组患者发生VTE/ATE的风险,探讨其临床影响,并研究潜在的临床风险因素。

使用内部药房记录筛选2015-2018年在维也纳医科大学接受免疫检查点抑制剂治疗的患者,共672位,最常见的肿瘤类型:黑色素瘤(30.4%)、非小细胞肺癌(24.1%)、IV期肿瘤(86%)。

采用回顾性方法筛选VTE和/或ATE。在竞争风险框架内分析了累积发生率和组间差异。应用多状态建模来研究VTE/ATE对死亡率的影响。

VTE和ATE的累积发生率

中位随访超过8.5个月,共有47例VTE和9例ATE。VTE和ATE的累积发生率分别是12.9%和1.8%。

VTE与预后的相关性

VTE的发生与死亡率增加有关(过渡风险比[THR] 3.09)。VTE病史可预测VTE的发生(子分布风险比[SHR] 3.69),远处转移与VTE风险无明显相关性(SHR 1.71)。未观察到VTE与ECOG表现状态、Charlson-合并症指数或Khorana评分相关,不同癌种和不同免疫检查点抑制剂之间的VTE发生率相当。

综上,采用免疫检查点抑制剂治疗的癌症患者具有较高的血栓栓塞风险,特别是VTE。而且,VTE发生于死亡率风险增加相关。

原始出处:

Florian Moik, et al. Incidence, risk factors and outcomes of venous and arterial thromboembolism in immune checkpoint inhibitor therapy. Blood. OCTOBER 16, 2020

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    2021-07-17 jklm09
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    2020-10-31 lovetcm

    采用#免疫检查点抑制剂#治疗的#癌症#患者具有较高的#血栓栓塞#风险,特别是#VTE#,事实上,如果在#免疫治疗#的同时,给予#抗血小板治疗#,如#阿司匹林#,或小剂量#抗凝治疗#,如#利伐沙班#,可能具有协同增效的作用,这是十分值得研究的事情

    0

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    2020-10-25 ms1000000831038577

    学习

    0

  4. 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  6. 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    2020-10-20 ms9000000222039314

    学习

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  7. 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    2020-10-20 ms9000000222039314

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  8. 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    2020-10-19 1244c0ebm28暂无昵称

    学习学习

    0

  9. 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    2020-10-19 Nebula-Qin

    优秀

    0

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    2020-10-19 carolinewy

    学习了

    0

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