在 COVID-19 时代，接受免疫检查点抑制剂治疗的黑色素瘤患者中肌炎和可能的心肌炎增多。

IF 4.6 2区医学 Q2 IMMUNOLOGY Cancer Immunology, Immunotherapy Pub Date : 2024-10-05 DOI:10.1007/s00262-024-03803-5

Allison L Gradone, Vincent T Ma, Alexi Vasbinder, Leslie A Fecher, Sarah Yentz, Salim S Hayek, Christopher D Lao

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引用次数: 0

摘要

背景：免疫检查点抑制剂（ICI）介导的心肌炎会导致严重的发病率和死亡率。在我们医院，我们注意到 ICI 介导的心肌炎病例的发病率有所上升，因此我们对接受 ICI 治疗的晚期黑色素瘤患者数据库进行了进一步调查：方法：对晚期黑色素瘤患者进行单中心回顾性队列分析，确定ICI介导的心肌炎和肌炎病例：从2014年9月至2019年10月，366名晚期黑色素瘤患者接受了ICI治疗。在这些患者中，ICI介导的心肌炎病例为0例（0%，95% CI 0%-1.0%），ICI介导的肌炎病例为2例（0.55%，95% CI 0.07%-1.96%）。从2019年11月到2021年12月，又发现了246例晚期黑色素瘤患者。在这些患者中，10人（4.1%，95% CI 1.97%-7.35%）发生了ICI介导的心肌炎，10人发生了ICI介导的肌炎：我们的研究表明，在 COVID-19 时代，ICI 介导的肌肉损伤（包括肌炎和心肌炎）的发病率有所上升。对这些患者进行区分并进一步进行风险分层，可为这一严重并发症的精细化管理制定指南。

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Increased myositis and possible myocarditis in melanoma patients treated with immune checkpoint inhibitors in the COVID-19 era.

Background: Immune checkpoint inhibitor (ICI)-mediated myocarditis results in significant morbidity and mortality. At our institution, we noted an increased incidence of ICI-mediated myocarditis cases, leading to further investigation in our database of advanced melanoma patients treated with ICI therapy.

Methods: A single-center, retrospective cohort analysis of patients with advanced melanoma identified cases of ICI-mediated myocarditis and myositis.

Results: 366 patients with advanced melanoma received a dose of ICI from September 2014 to October 2019. Of these patients, there were 0 cases of ICI-mediated myocarditis (0%, 95% CI 0%-1.0%) and 2 cases of ICI-mediated myositis (0.55%, 95% CI 0.07%-1.96%). From November 2019 to December 2021, an additional 246 patients with advanced melanoma were identified. Of these patients, 10 (4.1%, 95% CI 1.97%-7.35%) developed ICI-mediated myocarditis and 10 developed ICI-mediated myositis.

Conclusion: Our study suggests an increase in prevalence of ICI-mediated muscle damage including myositis and myocarditis in the COVID-19 era. Differentiation of these patients and further risk stratification may allow for development of guidelines for nuanced management of this serious complication.

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来源期刊

Cancer Immunology, Immunotherapy 医学-免疫学

CiteScore

10.50

自引率

1.70%

发文量

207

审稿时长

1 months

期刊介绍： Cancer Immunology, Immunotherapy has the basic aim of keeping readers informed of the latest research results in the fields of oncology and immunology. As knowledge expands, the scope of the journal has broadened to include more of the progress being made in the areas of biology concerned with biological response modifiers. This helps keep readers up to date on the latest advances in our understanding of tumor-host interactions. The journal publishes short editorials including "position papers," general reviews, original articles, and short communications, providing a forum for the most current experimental and clinical advances in tumor immunology.