Heinzerling Lucie, Goldinger Simone M
aDepartment of Dermatology, University Hospital Erlangen, Erlangen, Germany bDepartment of Dermatology, University Hospital Zurich, Zurich, Switzerland.
Curr Opin Oncol. 2017 Mar;29(2):136-144. doi: 10.1097/CCO.0000000000000358.
The aim of this article is to raise awareness of physicians for the serious side-effects of immune-checkpoint blocking antibodies. As checkpoint inhibitors can induce severe side-effects and are increasingly being used also in subspecialties besides dermatology and oncology, with less experience with these drugs available, knowledge has to be spread. Early recognition and adequate management is essential.
Recent reports on side-effects document cases of serious side-effects involving all organ systems. These include formerly little referenced and life-threatening side-effects such as cardiotoxicity and neurotoxicity. Furthermore, important additional findings are the inclusion of CMV reactivation in the differential diagnosis or the side-effect profile in special patient populations, that is, in transplant patients, patients with autoimmune disease or previous toxicity to ipilimumab.
Checkpoint inhibitor treatment induces a wide range of serious side-effects. However, with prompt diagnosis and adequate treatment these can mostly be safely managed. Documentation and reporting of serious side-effects remains important to share knowledge and thus ensure optimal patient care.
本文旨在提高医生对免疫检查点阻断抗体严重副作用的认识。由于检查点抑制剂可诱发严重副作用,且除皮肤科和肿瘤学外,越来越多地用于其他亚专业领域,而这些药物的使用经验较少,因此必须传播相关知识。早期识别和适当管理至关重要。
近期关于副作用的报告记录了涉及所有器官系统的严重副作用病例。这些包括以前很少提及的危及生命的副作用,如心脏毒性和神经毒性。此外,重要的其他发现包括在鉴别诊断中纳入巨细胞病毒再激活,或特殊患者群体(即移植患者、自身免疫性疾病患者或既往对伊匹单抗有过毒性反应的患者)的副作用特征。
检查点抑制剂治疗会诱发多种严重副作用。然而,通过及时诊断和适当治疗,这些副作用大多可以得到安全管理。记录和报告严重副作用对于分享知识从而确保最佳患者护理仍然很重要。