Delaunay M, Caron P, Sibaud V, Godillot C, Collot S, Milia J, Prévot G, Mazières J
Service de pneumologie, hôpital Larrey, centre hospitalier universitaire, université Paul-Sabatier, 31059 Toulouse, France.
Service d'endocrinologie, hôpital Larrey, centre hospitalier universitaire, université Paul-Sabatier, 31059 Toulouse, France.
Rev Mal Respir. 2018 Dec;35(10):1028-1038. doi: 10.1016/j.rmr.2017.08.006. Epub 2018 Sep 10.
Anti-tumoral immunotherapy is currently the basis of a profound modification of therapeutic concepts in oncology, in particular since the arrival of immune checkpoint inhibitors (ICI). In addition to their efficacy profile, these immune-targeted agents also generate adverse events. With the increasing use of ICI for a growing number of tumor types, awareness of immunotherapy-related adverse events is essential to ensure prompt diagnosis and effective management of these potentially serious adverse events.
Cytotoxic T-lymphocyte antigen 4 (CTLA4) and programmed cell death protein 1 (PD1) are two co-inhibitory receptors that are expressed on activated T cells against which therapeutic blocking antibodies have reached routine clinical use. Immune checkpoint blockade can induce inflammatory adverse effects, termed immune-related adverse events (irAEs), which resemble autoimmune disease. Though severe irAEs remain rare, they can be fatal if not diagnosed and treated in an appropriate manner.
Additional studies are needed to better understand the clinical characteristics and chronology of these adverse effects and to clarify their pathophysiological mechanisms.
抗肿瘤免疫疗法目前是肿瘤学治疗理念深刻变革的基础,尤其是自免疫检查点抑制剂(ICI)问世以来。除了其疗效外,这些免疫靶向药物还会产生不良事件。随着ICI在越来越多肿瘤类型中的使用日益增加,了解免疫疗法相关不良事件对于确保及时诊断和有效管理这些潜在严重不良事件至关重要。
细胞毒性T淋巴细胞抗原4(CTLA4)和程序性细胞死亡蛋白1(PD1)是两种共抑制受体,它们在活化的T细胞上表达,针对它们的治疗性阻断抗体已在临床常规使用。免疫检查点阻断可诱导炎症性不良效应,称为免疫相关不良事件(irAE),其类似于自身免疫性疾病。尽管严重的irAE仍然罕见,但如果未得到适当诊断和治疗,可能会致命。
需要进行更多研究,以更好地了解这些不良效应的临床特征和发生时间,并阐明其病理生理机制。