55例肿瘤患者免疫检查点抑制剂的临床应用和不良反应分析

Analysis in clinical application and adverse reactions of immunocheckpoint inhibitors in 55 patients with tumors

  • 摘要:
    目的 了解本院肿瘤科患者程序性死亡受体1(PD-1)抑制剂的临床应用与不良反应。
    方法 回顾性收集2020年1月-2021年12月在本院肿瘤内科使用PD-1抑制剂患者的临床资料,分析患者的基本信息、用药医嘱、联合治疗方案、影像学评价结果及不良反应。
    结果 55例患者中,男33例,女22例,平均年龄(63.26±11.23)岁,使用PD-1抑制剂共241次; 病理诊断主要为肺癌27例(49.09%)、肝癌10例(18.18%)、食管癌3例(5.45%)和宫颈癌3例(5.45%)等; 最常见的抗肿瘤方案是化疗联合免疫治疗、免疫治疗、靶向联合免疫治疗; 使用频率较高是信迪利单抗200 mg的3周1次方案、卡瑞利珠单抗200 mg的3周1次和2周1次方案; 44例患者发生药品不良反应,较为常见的是自身免疫性疾病(34.54%)、骨髓抑制(20.00%)和全身乏力(10.91%)。
    结论 PD-1抑制剂在本院肿瘤科的使用仍处于探索阶段,临床药师应积极配合临床医生做好药学监护工作。

     

    Abstract:
    Objective To understand the clinical application and adverse reactions of programmed death receptor 1 (PD-1) inhibitors in patients in the Department of Oncology in authors' hospital.
    Methods The clinical materials of patients using PD-1 inhibitors in the Department of Oncology in authors' hospital from January 2020 to December 2021 were retrospectively collected, and the general information, medication orders, combined therapeutic plans, imaging evaluation results and adverse reactions of patients were analyzed.
    Results Of the 55 patients, there were 33 males and 22 females, with an average age of (63.26±11.23) years and 241 times of PD-1 inhibitors in total; pathological diagnosis mainly included 27 cases of lung cancer (49.09%), 10 cases of liver cancer (18.18%), 3 cases of esophageal cancer (5.45%) and 3 cases of cervical cancer (5.45%); the most commonly used anti-tumor programs were chemotherapy combined with immunotherapy, immunotherapy, and targeted therapy combined with immunotherapy; the frequently used regimens were 200 mg sintilimab for once every three weeks and 200 mg camrelizumab for once every three weeks or once every two weeks; 44 patients had adverse drug reactions, and the most common types were autoimmune diseases (34.54%), bone marrow suppression (20.00%) and general fatigue (10.91%).
    Conclusion The application of PD-1 inhibitors in the Department of Oncology in the authors' hospital is still at the exploratory stage, and clinical pharmacists should actively cooperate with clinician to do a good job in pharmaceutical care.

     

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