Johnson Douglas B, Beckermann Kathryn E, Wang Daniel Y
Oncology (Williston Park). 2018 Apr 15;32(4):190-4.
Immune checkpoint inhibitors have demonstrated efficacy across many cancer types in numerous clinical trials. However, because patients with preexisting autoimmune disease were excluded from these seminal trials, there are serious gaps in knowledge regarding the efficacy-and in particular the safety-of these transformative agents in patients with autoimmune disease. The safety of immune checkpoint inhibitors in this population has been an important concern, since these agents unleash immune activation, a potentially dangerous situation for patients with already heightened and aberrant immune function. Several retrospective studies have begun to address this question, finding that autoimmunity is often exacerbated by immune checkpoint inhibitor therapy, but is generally manageable with standard treatment algorithms and close multidisciplinary monitoring. Further, the activity of these agents appears to be comparable to that seen in unselected patients. Here we detail the experience with immune checkpoint inhibitors in patients with autoimmune disease.
免疫检查点抑制剂在众多临床试验中已证明对多种癌症类型有效。然而，由于先前存在自身免疫性疾病的患者被排除在这些开创性试验之外，对于这些变革性药物在自身免疫性疾病患者中的疗效，尤其是安全性，存在严重的知识空白。免疫检查点抑制剂在这一人群中的安全性一直是一个重要问题，因为这些药物会引发免疫激活，这对于免疫功能已经亢进和异常的患者来说是一个潜在的危险情况。几项回顾性研究已开始探讨这个问题，发现免疫检查点抑制剂治疗常常会加剧自身免疫，但通过标准治疗方案和密切的多学科监测通常是可控的。此外，这些药物的活性似乎与在未经过挑选的患者中观察到的活性相当。在此，我们详细介绍自身免疫性疾病患者使用免疫检查点抑制剂的经验。
