Association of Preexisting Interstitial Lung Abnormalities With Immune Checkpoint Inhibitor-Induced Interstitial Lung Disease Among Patients With Nonlung Cancers.
Association of Preexisting Interstitial Lung Abnormalities With Immune Checkpoint Inhibitor-Induced Interstitial Lung Disease Among Patients With Nonlung Cancers.
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DOI：
10.1001/jamanetworkopen.2020.22906
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发表时间：
2020-11-02
影响因子：
13.8
通讯作者：
Hattori N
中科院分区：
文献类型：
--
作者：
Shimoji K;Masuda T;Yamaguchi K;Sakamoto S;Horimasu Y;Nakashima T;Miyamoto S;Iwamoto H;Fujitaka K;Hamada H;Takeno S;Hide M;Teishima J;Ohdan H;Hattori N
在非肺癌患者中，间质性肺异常是否与免疫检查点抑制剂诱导的间质性肺疾病有关？在这项对199名接受抗程序性细胞死亡1抗体单抗治疗的晚期非肺癌患者的队列研究中，先前存在间质性肺异常的患者显著增加了免疫检查点抑制剂诱导的间质性肺疾病的风险。这些发现表明，免疫检查点抑制物诱导的间质性肺疾病在非肺癌和间质性肺异常患者中的发展应给予更多的关注。这项队列研究评估了非肺癌患者的间质性肺异常是否与免疫检查点抑制剂诱导的间质性肺疾病有关。免疫检查点抑制物诱导的间质性肺病(ICI-ILD)是临床上严重且危及生命的疾病。先前存在的间质肺异常已被证明是肺癌患者ICI-ILD的危险因素。目的：探讨非肺癌患者肺间质病变是否与ICI-ILD相关。这项队列研究于2015年12月至2019年5月在广岛大学医院进行。共有199名头颈癌、恶性黑色素瘤、口腔癌、泌尿系癌症和胃肠癌患者接受了抗程序性细胞死亡1(PD-1)抗体的单一治疗。数据分析从2015年12月至2019年5月进行。研究潜在危险因素与ICI-ILD发展的关系。在注射抗体之前，获得了患者特征的信息，包括胸部计算机断层扫描的结果。ICI-ILD的诊断定义为抗PD-1抗体治疗期间出现的异常CT阴影。共有199名患者参加了这项研究。中位年龄为66岁(20-93岁)，大多数患者(133例，66.8%)为男性。19例(9.5%)发生ICI-ILD。ICI-ILD患者与非ICI-ILD患者的基线特征无显著差异。Logistic回归分析显示肺间质病变与ICI-ILD的危险性增加有关(优势比6.2 9；95%CI 2.34~16.92；P <； .0 0 1)，磨玻璃衰减是独立的危险因素(优势比4.0 5；95%CI 1.2 9~12.71；P = .0 1)。在这项队列研究中，先前存在的间质肺异常，包括毛玻璃衰减，是与非肺癌患者ICI-ILD相关的危险因素。这一观察结果与之前报道的肺癌患者的研究结果一致。因此，无论是哪种肿瘤类型，我们都应该更加重视ICI-ILD在肺间质病变患者中的发展。
Are interstitial lung abnormalities, which are minor interstitial shadows on lung computed tomography, associated with immune checkpoint inhibitor induced–interstitial lung disease in patients with nonlung cancers? In this cohort study of 199 patients with advanced nonlung cancers treated with anti–programmed cell death 1 antibody monotherapy, patients with preexisting interstitial lung abnormalities had significantly increased risk of immune checkpoint inhibitor induced–interstitial lung disease. These findings suggest that greater attention should be accorded to the development of immune checkpoint inhibitor induced–interstitial lung disease in patients with nonlung cancers and interstitial lung abnormalities. This cohort study evaluates whether interstitial lung abnormalities are associated with immune checkpoint inhibitor–induced interstitial lung disease in patients with nonlung cancers. Immune checkpoint inhibitor–induced interstitial lung disease (ICI-ILD) is clinically serious and life-threatening. Preexisting interstitial lung abnormalities have been shown to be risk factors for ICI-ILD in patients with lung cancer. To evaluate whether interstitial lung abnormalities are associated with ICI-ILD in patients with nonlung cancers. This cohort study was conducted between December 2015 and May 2019 at Hiroshima University Hospital. A total of 199 consecutive patients with head and neck cancer, malignant melanoma, oral cavity cancer, urological cancer, and gastrointestinal cancer who received anti–programmed cell death 1 (PD-1) antibody monotherapy were included. Data analysis was conducted from December 2015 to May 2019. The associations between potential risk factors and the development of ICI-ILD were examined. Information on patient characteristics before antibody administration, including chest computed tomography findings, was obtained. The diagnosis of ICI-ILD was defined as abnormal computed tomography shadows occurring during treatment with anti-PD-1 antibodies. A total of 199 patients were enrolled in the study. The median (range) age was 66 (20-93) years, and most patients (133 [66.8%]) were men. Nineteen patients (9.5%) developed ICI-ILD. There was no significant difference in the baseline characteristics between patients with and without ICI-ILD. The logistic regression analyses revealed that interstitial lung abnormalities were associated with increased risk of ICI-ILD (odds ratio, 6.29; 95% CI, 2.34-16.92; P < .001), and ground glass attenuation in interstitial lung abnormalities was an independently associated risk factor (odds ratio, 4.05; 95% CI, 1.29-12.71; P = .01). In this cohort study, preexisting interstitial lung abnormalities, including ground glass attenuation, were risk factors associated with ICI-ILD in patients with nonlung cancers. This observation is consistent with previously reported findings in patients with lung cancer. Therefore, we should pay more attention to the development of ICI-ILD in patients with interstitial lung abnormalities, regardless of cancer type.
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DOI：
10.1056/nejmoa1007285
发表时间：
2011-03-10
期刊：
The New England journal of medicine
影响因子：
--
作者：
Washko GR;Hunninghake GM;Fernandez IE;Nishino M;Okajima Y;Yamashiro T;Ross JC;Estépar RS;Lynch DA;Brehm JM;Andriole KP;Diaz AA;Khorasani R;D'Aco K;Sciurba FC;Silverman EK;Hatabu H;Rosas IO;COPDGene Investigators
通讯作者：
COPDGene Investigators
DOI：
10.1056/nejmoa1216076
发表时间：
2013-06-06
期刊：
The New England journal of medicine
影响因子：
--
作者：
Hunninghake GM;Hatabu H;Okajima Y;Gao W;Dupuis J;Latourelle JC;Nishino M;Araki T;Zazueta OE;Kurugol S;Ross JC;San José Estépar R;Murphy E;Steele MP;Loyd JE;Schwarz MI;Fingerlin TE;Rosas IO;Washko GR;O'Connor GT;Schwartz DA
通讯作者：
Schwartz DA
DOI：
10.1164/rccm.200710-1501oc
发表时间：
2008-06-15
影响因子：
24.7
作者：
Kudoh, Shoji;Kato, Harubumi;Nyberg, Fredrik
通讯作者：
Nyberg, Fredrik
影响因子：
5.3
作者：
Yamaguchi, Teppei;Shimizu, Junichi;Hida, Toyoaki
通讯作者：
Hida, Toyoaki
影响因子：
45.3
作者：
Weber, Jeffrey S.;Hodi, F. Stephen;Robert, Caroline
通讯作者：
Robert, Caroline