Hofmann Lars, Forschner Andrea, Loquai Carmen, Goldinger Simone M, Zimmer Lisa, Ugurel Selma, Schmidgen Maria I, Gutzmer Ralf, Utikal Jochen S, Göppner Daniela, Hassel Jessica C, Meier Friedegund, Tietze Julia K, Thomas Ioannis, Weishaupt Carsten, Leverkus Martin, Wahl Renate, Dietrich Ursula, Garbe Claus, Kirchberger Michael C, Eigentler Thomas, Berking Carola, Gesierich Anja, Krackhardt Angela M, Schadendorf Dirk, Schuler Gerold, Dummer Reinhard, Heinzerling Lucie M
Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Germany.
Department of Dermatology, University Hospital Tübingen, Germany.
Eur J Cancer. 2016 Jun;60:190-209. doi: 10.1016/j.ejca.2016.02.025. Epub 2016 Apr 13.
Anti-programmed cell death receptor-1 (PD-1) antibodies represent an effective treatment option for metastatic melanoma as well as for other cancer entities. They act via blockade of the PD-1 receptor, an inhibitor of the T-cell effector mechanisms that limit immune responses against tumours. As reported for ipilimumab, the anti-PD-1 antibodies pembrolizumab and nivolumab can induce immune-related adverse events (irAEs). These side-effects affect skin, gastrointestinal tract, liver, endocrine system and other organ systems. Since life-threatening and fatal irAEs have been reported, adequate diagnosis and management are essential.
In total, 496 patients with metastatic melanoma from 15 skin cancer centers were treated with pembrolizumab or nivolumab; 242 side-effects were described in 138 patients. In 116 of the 138 patients, side-effects affected the skin, gastrointestinal tract, liver, endocrine, and renal system. Rare side-effects included diabetes mellitus, lichen planus, and pancreas insufficiency due to pancreatitis.
Anti-PD1 antibodies can induce a plethora of irAEs. The knowledge of them will allow prompt diagnosis and improve the management resulting in decreased morbidity.
抗程序性细胞死亡受体1（PD-1）抗体是转移性黑色素瘤以及其他癌症实体的一种有效治疗选择。它们通过阻断PD-1受体发挥作用，PD-1受体是限制针对肿瘤的免疫反应的T细胞效应机制的抑制剂。如针对伊匹单抗所报道的那样，抗PD-1抗体派姆单抗和纳武单抗可诱发免疫相关不良事件（irAE）。这些副作用会影响皮肤、胃肠道、肝脏、内分泌系统和其他器官系统。由于已经报道了危及生命和致命的irAE，因此进行充分的诊断和管理至关重要。
来自15个皮肤癌中心的总共496例转移性黑色素瘤患者接受了派姆单抗或纳武单抗治疗；138例患者描述了242种副作用。在138例患者中的116例中，副作用影响了皮肤、胃肠道、肝脏、内分泌和肾脏系统。罕见的副作用包括糖尿病、扁平苔藓和胰腺炎导致的胰腺功能不全。
抗PD1抗体可诱发大量irAE。对它们的了解将有助于及时诊断并改善管理，从而降低发病率。
