摘要
免疫检查点抑制剂是针对相应免疫检查点的一些单抗类药物,发挥阻断肿瘤细胞对免疫细胞的抑制作用.基于免疫治疗特有的作用机制,其相关性毒副反应不同于其他癌症疗法,机体的所有器官均可累及,以皮肤、胃肠道、肝脏、内分泌和肺部毒性为多见,通常是轻微、可逆的,但严重的毒副反应可危及生命.因此,加强对其相关性不良事件的管理,减少中重度毒副反应的发生,对于提高免疫治疗的疗效至关重要.本文汇总各临床指南和最新研究,分别从临床表现和管理措施两个方面对抗细胞毒性T淋巴细胞相关抗原4单抗和抗程序性死亡受体1及其配体1单抗在治疗中的常见毒副作用进行综述,为临床更有效地处理免疫相关毒性事件提供参考.
Immune checkpoint inhibitors,which exert their antitumor effects by targeting suppressive immune molecules,are a class of monoclonal antibody drugs based on certain immune checkpoints.Cancer immunotherapies lead to unique toxicity profiles distinct from the toxicities of other cancer therapies,depending on their mechanism of action.Immune-related adverse events can involve any organ or system.These effects are frequently low grade and reversible,affecting the skin,gastrointestinal tract,liver,endocrine system,and lung most commonly.However,some adverse effects can be severe and life-threatening.Therefore,the effective management of immune-related adverse events and reducing the occurrence of grade 3-4 treatment-related adverse events are critical in optimizing treatment outcomes.In this review,we summarize the clinical guidelines and the latest studies,and focus on the common toxic effects and management of the adverse events related to anti-cytotoxic T lymphocyte-associated antigen-4 or programmed death-1/programmed deathligand-1 monoclonal antibody drugs,in order to provide better management of immune-related adverse events.
作者
李文宇
李灵常
霍介格
Wen-Yu Li;Ling-Chang Li;Jie-Ge Huo(The Third Clinical Medical College of Nanjing University of Chinese Medicine,Nanjing 210028,Jiangsu Province,China;Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing 210028,Jiangsu Province,China)
出处
《世界华人消化杂志》
CAS
2020年第16期755-764,共10页
World Chinese Journal of Digestology
基金
江苏省中医药领军人才项目,No.SLJ0211
国家中医临床研究基地课题,No.JD2019SZXYB04。
