Grover Shilpa, Rahma Osama E, Hashemi Nikroo, Lim Ramona M
From the Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA; Dana-Farber Cancer Institute, Brookline, MA.
Am Soc Clin Oncol Educ Book. 2018 May 23;38:13-19. doi: 10.1200/EDBK_100013.
Gastrointestinal toxicities are among the leading causes of immune-related adverse effects of checkpoint blockade. These adverse events can be severe enough to require interruption or withdrawal of immune checkpoint blockade therapy. Patients with immune-related adverse effects require early recognition with an evaluation to rule out alternative etiologies and effective management to minimize complications. This article reviews the gastrointestinal and hepatic toxicities of the antibodies that target immune checkpoints CTLA-4 and PD-1/PD-L1 and provides an approach to their diagnosis and management.
胃肠道毒性是检查点阻断免疫相关不良反应的主要原因之一。这些不良事件可能严重到需要中断或停止免疫检查点阻断治疗。患有免疫相关不良反应的患者需要早期识别并进行评估以排除其他病因,同时需要有效的管理措施以尽量减少并发症。本文综述了靶向免疫检查点CTLA-4和PD-1/PD-L1的抗体的胃肠道和肝脏毒性,并提供了其诊断和管理方法。