Lung cancer (LC) is a serious health problem worldwide. Survival outcomes have improved over time due to the widespread use of novel therapeutic agents, including immune checkpoint inhibitors (ICIs). Endocrine immune-related adverse events (e-irAEs) are common in LC patients treated with ICIs. We performed a retrospective study of patients with LC who received treatment with ICIs at a tertiary referral center between January 2014 and October 2023. In total, 983 LC patients were included in the study. E-irAEs presented at a median time of 4.1 months and included hypothyroidism (15.6%), hyperthyroidism (4.3%), adrenal insufficiency (0.4%), hypophysitis (0.4%), and diabetes mellitus (0.2%). These toxicities were not related to the duration of treatment or the type of ICIs. Most (97.6%) e-irAEs were mild (grade 1–2). Median overall survival (OS) was higher in LC patients who experienced e-irAEs (31.6 months) compared to those who did not (10.8 months). The difference remained statistically significant in the 3-month (HR: 0.42) and 6-month landmark analysis (HR: 0.51). The OS advantage was observed in both patients with NSCLC (HR: 0.36) and SCLC (HR: 0.27). Additional research is needed to validate the role of e-irAEs as an independent predictor of survival outcomes in patients with LC.
肺癌是全球范围内严重的健康问题。随着免疫检查点抑制剂等新型治疗药物的广泛应用，患者生存结局已得到改善。在接受免疫检查点抑制剂治疗的肺癌患者中，内分泌免疫相关不良事件较为常见。本研究回顾性分析了2014年1月至2023年10月期间在某三级转诊中心接受免疫检查点抑制剂治疗的肺癌患者。共纳入983例肺癌患者。内分泌免疫相关不良事件的中位发生时间为4.1个月，包括甲状腺功能减退（15.6%）、甲状腺功能亢进（4.3%）、肾上腺功能不全（0.4%）、垂体炎（0.4%）和糖尿病（0.2%）。这些毒性反应与治疗持续时间或免疫检查点抑制剂类型无关。绝大多数（97.6%）内分泌免疫相关不良事件为轻度（1-2级）。发生内分泌免疫相关不良事件的肺癌患者中位总生存期（31.6个月）显著高于未发生者（10.8个月）。在3个月（风险比：0.42）和6个月（风险比：0.51）界标分析中，该差异仍具有统计学意义。这种生存优势在非小细胞肺癌（风险比：0.36）和小细胞肺癌（风险比：0.27）患者中均得到证实。需要进一步研究验证内分泌免疫相关不良事件作为肺癌患者生存结局独立预测因子的作用。
肿瘤(癌症)患者之家