Objectives To investigate factors associated with DM complete clinical response and overall survival with a focus on the use of immunosuppressive therapies in patients with cancer-associated DM. Methods We performed a multicentre, retrospective cohort study. Multivariable survival analyses used a Cox model with time-dependent covariates and adjustments with inverse probability censoring weighting. Results We included 73 patients with cancer-associated DM. Median follow-up was 3.92 years. Overall, 40 (54.8%) patients achieved cancer remission, with DM complete clinical response in 28/40 (70.0%). DM complete clinical response was associated with cancer remission (hazard ratio [HR] 2.46, 95% CI [1.13–5.32]) and younger age (HR 0.68, 95% CI [0.49–0.95]). Risk of mortality was associated with sustained cancer activity (HR 12.93, 95% CI [2.42–69.25]), male sex (HR 2.82, 95% CI [1.19–6.70]), and older age (HR 1.86, 95% CI [1.26–2.79]) but not sustained DM activity (HR 0.40, 95% CI [0.13–1.26]). Oral corticosteroid use was a protective factor only on univariate analysis (HR 0.18, 95% CI [0.08–0.42]). Conclusion This study provides strong evidence of a significant association between the evolutions of DM and cancer, both in terms of overall survival and DM complete clinical response. Immunosuppressive treatments for DM were not significantly associated with mortality. Trial registration ClinicalTrials.gov, NCT04637672.

中文翻译：

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癌症相关性皮肌炎患者的预后因素：一项针对 73 例患者的回顾性多中心队列研究


目的 探讨与 DM 完全临床反应和总生存期相关的因素，重点关注免疫抑制疗法在癌症相关 DM 患者中的使用。方法 我们进行了一项多中心、回顾性队列研究。多变量生存分析使用具有时间依赖性协变量和具有逆概率删失加权的调整的 Cox 模型。结果 我们纳入了 73 例癌症相关 DM 患者，中位随访时间为 3.92 年。总体而言，40 例 （54.8%） 患者实现了癌症缓解，其中 DM 完全临床缓解为 28/40 （70.0%）。DM 完全临床缓解与癌症缓解 （HR 2.46， 95% CI [1.13–5.32]） 和年龄较小 （HR 0.68， 95% CI [0.49–0.95]）相关。死亡风险与持续的癌症活动度（HR 12.93， 95% CI [2.42–69.25]）、男性（HR 2.82， 95% CI [1.19–6.70]）和年龄较大（HR 1.86， 95% CI [1.26–2.79]）相关，但与持续的DM活动度无关（HR 0.40， 95% CI [0.13–1.26]）。口服皮质类固醇的使用仅在单变量分析中是一个保护因素（HR 0.18， 95% CI [0.08–0.42]）。结论 本研究提供了强有力的证据，证明 DM 的演变与癌症之间存在显着关联，无论是在总生存期还是 DM 完全临床反应方面。DM 的免疫抑制治疗与死亡率无显著相关性。试验注册 ClinicalTrials.gov，NCT04637672。