某院PD-1/PD-L1抑制剂免疫治疗相关性不良反应分析

Analysis of Adverse Reactions Related to Immunotherapy with PD-1/PD-L1 Inhibitors in One Hospital

目的分析我院肿瘤患者在使用程序性细胞死亡蛋白-1/受体配体-1(PD-1/PD-L1)抑制剂期间的不良反应发生情况。方法通过HIS系统及不良反应上报系统回顾性调查2019年1月1日~2022年5月1日在本院接受PD-1/PD-L1抑制剂治疗的肿瘤患者,记录患者发生免疫性相关不良反应的信息,并进行相关性分析。结果抽查379例使用了PD-1/PD-L1抑制剂的患者,共发生了66次免疫相关性不良反应,常见类型包括免疫性肺炎(3.69%)、免疫性肝炎(2.90%)和免疫性心脏毒性(2.11%)等,输液反应虽不是免疫相关性不良反应,但发生率同样较高(2.37%)。另外,在所监测的药物中,不良反应发生率较高的PD-1抑制剂有帕博利珠单抗(55.56%)、纳武利尤单抗(23.53%)、卡瑞利珠单抗(14.38%)、信迪利单抗(13.58%)。结论PD-1/PD-L1抑制剂引起的不良反应总体发生率不高,但各PD-1/PD-L1抑制剂之间免疫相关性不良反应的发生率和不同的不良反应发生率均有一定的差异,在临床选药时应根据患者情况选择合适的PD-1/PD-L1抑制剂及做个体化不良反应监测。

OBJECTIVE To analyze the immune related adverse reactions(IrAEs)of tumor patients during the use of Programmed Cell Death-1/Programmed Cell Death-Ligand 1(PD-1/PD-L1)inhibitors in our hospital.METHODS Through the HIS and adverse reaction reporting system,the tumor patients who received PD-1/PD-L1 inhibitors in our hospital from January 1,2019 to May 1,2022 were retrospectively investigated.Finally,we recorded and analyzed the information of IrAEs.RESULTS A total of 66 IrAEs occurred in 379 patients who used PD-1/PD-L1 inhibitors.The common types included pneumonia(3.69%),Hepatitis(2.90%)and cardiotoxicity(2.11%).Although infusion reactions were not IrAEs,the incidence was high(2.37%).In addition,the PD-1/PD-L1 inhibitors with high incidence of adverse reactions were Pembrolizumab(55.56%),Nivolumab(23.53%),Camrelizumab(14.38%),and Sintilimab(13.58%).CONCLUSION In our study,the overall incidence of IrAEs is not high,but the types and incidence rate of IrAEs are different in different PD-1/PD-L1 inhibitors.So we can select better drug according to patients′conditions and individual adverse reaction monitoring should be done.