Kuo Hsiao-Hsuan, Chen Wei-Wu
MSN, RN, Nurse Practitioner, Department of Nursing, National Taiwan University Hospital, Taiwan, ROC.
MD, Attending Physician, Department of Oncology, National Taiwan University Hospital, Taiwan, ROC.
Hu Li Za Zhi. 2018 Jun;65(3):88-95. doi: 10.6224/JN.201806_65(3).12.
Immune checkpoint inhibitors (ICIs) have become the new posterchild of cancer treatment in recent years largely due to their impressive clinical efficacy. Drugs targeting cytotoxic T- lymphocyte-associated antigen 4 (CTLA-4) and programmed cell death-1 (PD-1) antibodies, e.g., ipilimumab (Yervoy®), pembrolizumab (Keytruda®), and nivolumab (Opdivo®), reinvigorate cytotoxic T cells to kill cancer cells in patients. Despite the impressive clinical benefits, ICIs may induce immune-related adverse events (irAE) of the skin, gastrointestinal tract, liver, endocrine, and lung with a wide spectrum of severity. Rare but severe irAEs of critical organs such as the heart and central nervous system have also been reported. Clinical practitioners must recognize the early signs and symptoms of irAE as well as related management strategies.
近年来，免疫检查点抑制剂（ICIs）已成为癌症治疗的新典范，这主要归功于其令人瞩目的临床疗效。靶向细胞毒性T淋巴细胞相关抗原4（CTLA-4）和程序性细胞死亡蛋白1（PD-1）抗体的药物，如伊匹单抗（Yervoy®）、帕博利珠单抗（Keytruda®）和纳武单抗（Opdivo®），可使细胞毒性T细胞恢复活力，从而杀死患者体内的癌细胞。尽管ICIs带来了令人印象深刻的临床益处，但它们可能会引发皮肤、胃肠道、肝脏、内分泌和肺部的免疫相关不良事件（irAE），其严重程度范围广泛。也有报道称，心脏和中枢神经系统等重要器官会出现罕见但严重的irAE。临床医生必须认识到irAE的早期体征和症状以及相关的管理策略。
