Department of Supportive Care, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA.
Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
J Pain Symptom Manage. 2018 Sep;56(3):460-472. doi: 10.1016/j.jpainsymman.2018.05.015. Epub 2018 May 22.
Immune checkpoint inhibitors (ICIs) have opened an exciting chapter in the treatment of patients with advanced cancer. For the palliative care clinician, however, ICIs present several new challenges, including new ways to define treatment success, as well as treatment-related toxicities that differ in nature and timing from traditional chemotherapy. In this article, we review the mechanism of action of ICIs, as well as selected published data supporting the efficacy of ICIs in patients with advanced cancer. In addition, we summarize existing data of ICI toxicity prevalence, patterns of severity, and timing of onset. Finally, we briefly review key principles from published guidelines on the management of ICI toxicities.
免疫检查点抑制剂 (ICIs) 为晚期癌症患者的治疗开辟了令人兴奋的新篇章。然而,对于姑息治疗临床医生来说,ICIs 带来了一些新的挑战,包括定义治疗成功的新方法,以及与传统化疗在性质和时间上不同的治疗相关毒性。在本文中,我们回顾了 ICI 的作用机制,以及支持 ICI 在晚期癌症患者中疗效的选定已发表数据。此外,我们总结了 ICI 毒性发生率、严重程度模式和发病时间的现有数据。最后,我们简要回顾了已发表指南中关于 ICI 毒性管理的关键原则。