Study Of IrAEs Caused By Camrelizumab For Malignant Tumors And Related Factors

Purpose:Immune Checkpoint Inhibitors(ICIs)for malignant tumors is a new therapeutic approach after surgery,radiotherapy,chemotherapy,and biologic targeted therapy,and immunotherapy is often associated with immune-related adverse events(irAEs)while bringing therapeutic efficacy to patients.adverse events(irAEs)occur.During the treatment period,it is necessary to monitor the possible irAEs at all times and to make necessary clinical interventions.The aim of this study was to analyze the incidence and clinical manifestations of irAEs caused by the immune checkpoint inhibitor Camrelizumab,which is commonly used in clinical practice to treat patients with malignancies,and to analyze the factors that may be associated with the occurrence of irAEs.Method:This study used retrospective analysis with data from clinical data of patients with malignant tumors treated with Camrelizumab in Dalian Central Hospital Hospital from September 2020 to June 2022,and descriptive statistical analysis was performed using SPSS24.0 statistical software to determine whether irAEs occurred in patients with inclusion criteria,and logistic regression analysis was used to study the correlation between the use of Camrelizumab in patients with tumors The correlation between the occurrence of irAEs during treatment with Camrelizumab and the general clinical characteristics,antibiotic and hormone use,peripheral blood cell parameters and blood biochemical parameters of tumor patients was investigated using logistic regression analysis.Result:1.A total of 78 patients with esophageal,lung,and liver cancers who met the criteria were included in this study.Among the 78 patients,irAEs occurred in 57 patients,with G1 grade accounting for 49.20%,G2 grade accounting for 48.15%,G3 grade accounting for 2.65%,and G4 and G5 grade not occurring.2.Of the 57 patients who developed irAEs,the skin and its adnexa(51.06%),endocrine system(32.01%),immune-related gastrointestinal toxicity(5.56%),immunerelated pulmonary toxicity(5.29%),immune-related hepatic toxicity(5.02%),and cardiovascular system(1.06%)were mainly involved;of the accumulated endocrine systems,hyperthyroidism accounted for 5.82%,hypothyroidism(18.52%),and pituitary hormone abnormalities(7.67%).3.Of the 57 patients who developed irAEs,14(24.56%)developed irAEs in cycle1,20(35.09%)in cycle 2,17(29.82%)in cycle 3,and 6(10.53%)in cycle 3 onwards,the latest after 1 year of immunotherapy.4.The results of univariate Logistic regression analysis showed that according to the score of Eastern Cooperative Oncology Group,the score was 1 point(P=0.035,OR12.500,95% CI 1.193-130.969),and Camrelizumab alone(P=0.011,OR 17.500,95%CI 1.905—160.767),chemotherapy combined with Camrelizumab(P=0.011,OR17.500,95%CI 1.905—160.767),ICIs clinical response(Complete response,Partial response,CR+PR)(P=0.033,OR 4.571,95%CI 1.134—18.430),high neutrophillymphocyte ratio(NLR)(P=0.005,OR 1.912,95%CI 1.212—3.015),high plateletlymphocyte ratio(PNI)(P=0.007,OR 1.032,95%CI 1.008—1.055),and high serum albumin-fibrinogen ratio(AFR)(P=0.001,OR 1.441,95%CI 1.172—1.772),the differences were statistically significant,which were the risk factors of irAEs caused by tumor treated with Camrelizumab.5.Multivariate Logistic regression analysis showed that high NLR(P=0.023,OR2.296,95% CI 1.128-5.259)、high PNI(P=0.043,OR 1.047,95%CI 1.002—1.096)、high AFR(P=0.002,OR 2.296,95%CI 1.371—3.845).Among them,the difference of high AFR is significant,which belongs to the independent risk factors of irAEs caused by Camrelizumab.Conclusion:1.The clinical characteristics and patient characteristics of patients with esophageal,lung,and hepatocellular carcinoma with irAEs occurring after the use of Camrelizumab alone or in combination with chemotherapy were counted for inclusion criteria.2.It was found that patient ECOG score of 1,Camrelizumab alone,combination,and clinical remission(CR+PR)in the efficacy class of ICIs were associated with the occurrence of irAEs in patients with statistically significant differences.3.The biomarkers included in the study were found to be statistically significant differences in high NLR,high PNI,and high AFR,which were risk factors for irAEs due to tumors treated with Camrelizumab;among them,the difference in high AFR was significant and was an independent risk factor for the occurrence of irAEs.