Tofacitinib for the treatment of immune-related adverse events in cancer immunotherapy: a multi-center observational study

作者：Qing Liu, Mengling Liu, Zhiguo Zou, Jinyi Lin, Ning‐Ping Zhang, Lin Zhao, Jiahua Zhou, Haojie Zhou, Xin Zhou, Xiao‐Dong Jiao, Yiyi Yu, Tianshu Liu · 发表于：Journal of Translational Medicine · 年份：2024 · DOI：10.1186/s12967-024-05617-6 · 被引用次数：21 · 研究领域：Cancer Immunotherapy and Biomarkers、Lung Cancer Treatments and Mutations、CAR-T cell therapy research

BACKGROUND: Treatment strategy against immune-related adverse events (irAEs) induced by immune checkpoint inhibitors (ICIs) frequently requires other immunosuppressive agents. Tofacitinib is a rapidly acting JAK-STAT inhibitor with proven efficacy in multiple autoimmune diseases. We aimed to evaluate the efficacy and safety of tofacitinib in the management of irAEs in cancer patients. METHODS: Cancer patients who received ICIs and were treated with tofacitinib for the management of irAEs at 6 institutions were retrospectively included in this study. Demographic and clinical characteristics were obtained from electronic medical records. Longitudinal assessment of cardiac troponin T (cTnT) with clinical assessment was utilized to evaluate the benefit of tofacitinib treatment in patients with ICI myocarditis. Overall survival (OS) was also assessed. RESULTS: Fifty-three patients were included in this study. The median time from irAE onset to tofacitinib therapy was 17 (range, 2-186) days and the median duration of tofacitinib treatment was 52.5 (range, 3-277) days. Enrolled patients were subdivided into 3 groups based on clinical severity and steroid responsiveness including 11 life-threatening cases, 30 steroid-resistant cases, and 12 cases with steroid taper failure. Clinical remission rate in each group was 54.5%, 96.7%, and 100%, respectively (P < 0.01). Tofacitinib was well-tolerated with 4 patients (7.5%) developing infectious events. From the ICI initiation, the overall m...