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免疫检查点抑制剂引起的内分泌功能障碍:诊断和临床管理的实用建议。

Endocrine dysfunction induced by immune checkpoint inhibitors: Practical recommendations for diagnosis and clinical management.

机构信息

Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.

Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, Massachusetts.

出版信息

Cancer. 2018 Mar 15;124(6):1111-1121. doi: 10.1002/cncr.31200. Epub 2018 Jan 3.

Abstract

Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy. However, because ICIs block coinhibitory molecules on T cells and other immune cells, unleashing them to mediate tumor cell killing, they also can disrupt the maintenance of immunological tolerance to self-antigens. Compared with chemotherapy, ICIs have a different toxicity profile, especially the occurrence of autoimmune-like manifestations against multiple organ systems, including endocrine glands, commonly referred to as immune-related adverse events. The aim of this review was to provide practical recommendations regarding the proper assessment and clinical management related to the new onset of endocrinopathies after the use of ICIs in patients with cancer. Cancer 2018;124:1111-21. © 2018 American Cancer Society.

摘要

免疫检查点抑制剂(ICIs)彻底改变了癌症治疗。然而,由于 ICI 阻断 T 细胞和其他免疫细胞上的共抑制分子,从而释放它们来介导肿瘤细胞杀伤,它们也可能破坏对自身抗原的免疫耐受的维持。与化疗相比,ICI 具有不同的毒性特征,特别是针对包括内分泌腺在内的多个器官系统发生自身免疫样表现,通常称为免疫相关不良事件。本综述的目的是提供关于癌症患者使用 ICI 后新发内分泌疾病的适当评估和临床管理的实用建议。癌症 2018;124:1111-21。©2018 美国癌症协会。

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