Cutaneous and Noncutaneous Adverse Effects in Patients with Advanced Melanoma Receiving Immunotherapy.
Cutaneous and Noncutaneous Adverse Effects in Patients with Advanced Melanoma Receiving Immunotherapy.
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DOI：
10.1016/j.xjidi.2023.100232
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发表时间：
2023-11
期刊：
影响因子：
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通讯作者：
Chen, Suephy C
中科院分区：
文献类型：
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作者：
Yeung, Howa;Supapannachart, Krittin J;Francois, Sandy;Adler, Colin H;Kudchadkar, Ragini R;Lawson, David H;Yushak, Melinda L;Shariff, Afreen I;Chen, Suephy C
黑色素瘤免疫治疗的皮肤不良反应（CAEs）和非皮肤不良反应（NCAEs）之间的关系可能有助于识别与不同免疫途径相关的模式。本研究的目的是确定接受免疫治疗的III-IV期黑色素瘤患者和入组前瞻性队列的患者之间的CAE和NCAE之间的相关性。从首次免疫治疗输注至1年后提取电子病历数据。CAE表现为皮疹或瘙痒。NCAE是记录为免疫治疗相关的症状和/或实验室检查异常。使用OR和Wilcoxon秩和检验比较有和无CAE的受试者之间的NCAE发作和至NCAE的时间。在34例受试者中，11例（32.4%）未发生不良反应，7例（20.1%）仅发生CAE，3例（8.8%）仅发生NCAE，13例（38.2%）发生CAE和NCAE。在调整年龄、性别和免疫治疗方案后，CAE与NCAE发展的更高几率相关（OR = 9.72; 95%置信区间= 1.2-76.8）。中位NCAE发作时间为63天，在那些有CAE和168天，在那些没有CAE（P = 0.41）。局限性包括样本量小，需要进行更大规模的前瞻性研究来证实结果。CAE与NCAE的发展有关。NCAEs的早期识别和治疗可以减少与NCAEs相关的症状负担和住院治疗。
Relationships between cutaneous adverse effects (CAEs) and noncutaneous adverse effects (NCAEs) of melanoma immunotherapy may help identify patterns tied to distinct immunologic pathways. The objective of this study was to determine the associations between CAEs and NCAEs among patients with stages III–IV melanoma receiving immunotherapy and who were enrolled in a prospective cohort. Electronic medical record data were abstracted from the first immunotherapy infusion until 1 year later. CAEs were rash or itch. NCAEs were symptoms and/or laboratory abnormalities documented as immunotherapy related. NCAE onset and time to NCAE were compared between participants with and without CAEs using ORs and Wilcoxon rank sum tests. Of 34 participants, 11 (32.4%) developed no adverse effects, 7 (20.1%) developed CAEs only, 3 (8.8%) developed NCAEs only, and 13 (38.2%) developed both CAEs and NCAEs. After adjustment for age, sex, and immunotherapy regimen, CAE was associated with higher odds of NCAE development (OR = 9.72; 95% confidence interval = 1.2–76.8). Median NCAE onset was 63 days in those with CAEs and 168 days in those without CAEs (P = 0.41). Limitations included a small sample size, and larger prospective studies should be performed to confirm findings. CAE was associated with NCAE development. Early identification and treatment of NCAEs may reduce symptom burden and hospitalizations associated with NCAEs.