Analysis of adverse reactions and influencing factors of programmed death receptor 1 inhibitors in the treatment of malignant melanoma
Objective:To analyze the clinical features and risk factors of adverse reactions(ADRs)caused by programmed death receptor 1(PD-1)inhibitors in malignant melanoma(MM),and provide reference for safe drug use.Methods:A retrospective analysis was used to collect the clinical data of 126 MM patients treated with PD-1 inhibitors in our hospital.The influences of general information such as gender,age,disease stage with or without underlying diseases on ADRs were observed,and the involved organs,clinical manifestations,severity,occurrence time,treatment and outcome of ADRs were analyzed and summarized.Results:Among the 126 patients 81 had ADRs of different severity,grade 1～2 in 64 patients(50.8％),grade 3 of above in 17 patients(13.5％),and the median age was 56 years(6～84 y).Age,underlying disease,history of ADRs and combination of anti-tumor drugs increased the occurrence of adverse reactions(P＜0.05).The top five clinical manifestations were hypothyroidism(27.78％),TG elevation(15.08％),ALT elevation(13.49％),nausea(11.90％),and itching(11.90％).The occurrence time of ADRs was scattered,among which hepatotoxicity occurred earlier and hypothyroidism occurred later.Of the 81 patients with adverse reactions,59(73％)had improved symptoms,24(29.6％)were treated with immunosuppressant such as glucocorticoids,and 6(7.41％)were treated with other immunosuppressant.Conclusion:PD-1 inhibitor-related ADRs are mostly mild,and the incidence of grade 3 or above ADRs is low,which can be improved or cured by steroid hormone treatment.Advanced age,underlying diseases,and a history of ADRs can increase the incidence of ADRs,which should be paid attention to in clinic.
malignant melanomaprogrammed cell death 1 receptoradverse drug reactionsroot cause analysis
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