免疫检查点抑制剂引起内分泌相关不良反应的发生率及相关因素分析OA

Objective:To analyze incidence and differences of endocrine-related adverse reactions caused by long-term use of immune checkpoint inhibitors(ICI)in pan-cancer tumors.Methods:From April 2020 to December 2020,clinical data of patients with pan-cancer tumors diagnosed by pathology in Xijing Hospital,the First Affiliated Hospital of Air Force Military Medical University who received ICI at least 6 cycles were retrospectively analyzed,endocrine-related adverse reactions caused by ICI and its clinical fea-tures were summarized.Results:Among 136 patients who received immunotherapy,95 patients(69.8%)had abnormal thyroid func-tion,48 patients(35.3%)with abnormal blood sugar,and 10 patients(7.4%)had adrenal hypofunction.Endocrine-related adverse effects varied in age,tumor type and whether received chemotherapy in past,among which melanoma,young patients who had not re-ceived chemotherapy in past had a higher probability of adverse immune reactions.Compared with patients with thyroid dysfunction,patients without thyroid dysfunction had differences in age,BMI,tumor type,and previous chemotherapy treatment.Older age,higher BMI,and previous chemotherapy treatment could reduce occurrence of thyroid dysfunction.However,patients who had previously received chemotherapy were more likely to had abnormal glucose metabolism after ICI.Conclusion:Endocrine adverse reactions such as abnormal thyroid function,abnormal glucose metabolism,and primary adrenal insufficiency may occur in patients with malignant tumors treated with ICI.For young patients and melanoma patients,more vigilance should be paid to occurrence of endocrine adverse reactions.