当前位置: X-MOL 学术Lung Cancer › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Safety and efficacy of immune checkpoint inhibitors in patients with non-small cell lung cancer and hepatitis B or hepatitis C infection.
Lung Cancer ( IF 5.3 ) Pub Date : 2020-02-24 , DOI: 10.1016/j.lungcan.2020.02.013
Ana Pertejo-Fernandez 1 , Biagio Ricciuti 1 , Sarah P Hammond 2 , Francisco M Marty 2 , Gonzalo Recondo 1 , Deepa Rangachari 3 , Daniel B Costa 3 , Mark M Awad 1
Affiliation  

OBJECTIVES The safety and efficacy of immunotherapy among patients with history of hepatitis B (HBV) or hepatitis C virus (HCV) infection and non-small cell lung cancer (NSCLC) remains unclear as this population has traditionally been excluded from clinical trials with immune checkpoint inhibitors (ICIs). MATERIALS AND METHODS We retrospectively evaluated treatment toxicities and clinical outcomes in nineteen patients with NSCLC and history of past or chronic HBV (16 cases, two of these had HCV co-infection) or chronic HCV infection (five cases), who received a programmed death-1 (PD-1) pathway inhibitor. RESULTS The overall response rate to immunotherapy was 35 %, and the median progression-free survival was 4.5 months. After ICI initiation, increases in liver function tests (LFTs) from baseline were infrequent and mild, and no patients experienced grade 3 or 4 hepatic immune-related adverse events or required ICI discontinuation or corticosteroid administration for management of hepatic toxicity. There were no significant changes in viral load or cases of HBV reactivation or HCV flare while on ICI therapy. CONCLUSION In this case series, treatment with immunotherapy in patients with NSCLC and past or chronic viral hepatitis appears to be safe, and responses to ICIs can be durable in this population. Additional studies are needed in larger cohorts of patients to determine the safety of immunotherapy in patients with chronic viral infections.

中文翻译:

免疫检查点抑制剂在非小细胞肺癌和乙型或丙型肝炎感染患者中的安全性和有效性。

目的尚不清楚乙型肝炎(HBV)或丙型肝炎病毒(HCV)感染史以及非小细胞肺癌(NSCLC)病史患者的免疫疗法安全性和有效性,因为该人群传统上已被排除在具有免疫检查点的临床试验之外抑制剂(ICIs)。材料和方法我们回顾性评估了19例NSCLC患者的治疗毒性和临床结局,以及既往或计划性死亡的既往或慢性HBV病史(16例,其中2例是HCV合并感染)或慢性HCV感染(5例)。 -1(PD-1)途径抑制剂。结果对免疫疗法的总缓解率为35%,中位无进展生存期为4.5个月。在开始ICI后,肝功能检查(LFT)从基线开始的增加并不常见且轻度,而且没有患者经历过3或4级肝脏免疫相关的不良事件,也没有需要中断ICI或使用皮质类固醇激素来管理肝毒性。在ICI治疗期间,病毒载量或HBV再激活或HCV耀斑病例均无明显变化。结论在该病例系列中,对非小细胞肺癌和既往或慢性病毒性肝炎患者进行免疫疗法治疗似乎是安全的,并且对该人群的ICI反应可以持久。需要对更多的患者进行进一步的研究,以确定在慢性病毒感染患者中免疫治疗的安全性。在ICI治疗期间,病毒载量或HBV再激活或HCV耀斑病例均无明显变化。结论在该病例系列中,对非小细胞肺癌和既往或慢性病毒性肝炎患者进行免疫疗法治疗似乎是安全的,并且对该人群的ICI反应可以持久。需要对更多的患者进行进一步的研究,以确定在慢性病毒感染患者中免疫治疗的安全性。在ICI治疗期间,病毒载量或HBV再激活或HCV耀斑病例均无明显变化。结论在该病例系列中,对非小细胞肺癌和既往或慢性病毒性肝炎患者进行免疫疗法治疗似乎是安全的,并且对该人群的ICI反应可以持久。需要对更多的患者进行进一步的研究,以确定在慢性病毒感染患者中免疫治疗的安全性。
更新日期:2020-02-24
down
wechat
bug