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[免疫检查点抑制剂相关内分泌不良事件的临床实践与机制]

[Clinical practice and mechanism of endocrinological adverse events associated with immune checkpoint inhibitors].

作者信息

Iwama Shintaro, Arima Hiroshi

机构信息

Research Center of Health, Physical Fitness and Sports, Nagoya University.

Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine.

出版信息

Nihon Rinsho Meneki Gakkai Kaishi. 2017;40(2):90-94. doi: 10.2177/jsci.40.90.

Abstract

Immune checkpoint inhibitors, used for cancer immunotherapy, show anti-tumor effects through T cell activations. Monoclonal antibodies against cytotoxic T lymphocyte antigen-4 (CTLA-4), programmed cell death (PD)-1, or PD-ligand 1 which is a ligand of PD-1 have been shown to be effective in the treatments of advanced cancers including malignant melanoma, non-small cell lung cancer, and renal cell carcinoma. However, these drugs also have immune-related adverse events (irAEs). The irAEs, which have unique characteristics different from those seen in conventional cytotoxic anti-tumor medicines, are observed in the several tissues such as skin, gastrointestinal tract, liver, lung, muscle, nerve and endocrine systems. To safely use immune checkpoint inhibitors, it is quite important to understand the characteristics of irAEs and to manage them in clinical practice. In this review, we focus on clinical characteristics and pathogenesis of adverse events in the pituitary gland.

摘要

用于癌症免疫治疗的免疫检查点抑制剂通过激活T细胞发挥抗肿瘤作用。抗细胞毒性T淋巴细胞抗原4(CTLA-4)、程序性细胞死亡蛋白1(PD-1)或作为PD-1配体的PD-配体1的单克隆抗体已被证明在治疗包括恶性黑色素瘤、非小细胞肺癌和肾细胞癌在内的晚期癌症中有效。然而,这些药物也会引发免疫相关不良事件(irAE)。irAE在皮肤、胃肠道、肝脏、肺、肌肉、神经和内分泌系统等多个组织中出现,具有与传统细胞毒性抗肿瘤药物不同的独特特征。为了安全使用免疫检查点抑制剂,了解irAE的特征并在临床实践中对其进行管理非常重要。在本综述中,我们重点关注垂体不良事件的临床特征和发病机制。

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