Division of Early Drug Development for Innovative Therapies, European Institute of Oncology, via Ripamonti 435, 20141 Milan, Italy.
Division of Internal Medicine and Liver Unit, Department of Medicine San Paolo Hospital School of Medicine, University of Milan, via di Rudiní 8, 20142, Milan, Italy.
Crit Rev Oncol Hematol. 2018 Dec;132:125-129. doi: 10.1016/j.critrevonc.2018.09.019. Epub 2018 Oct 3.
Immune checkpoint inhibitors have revolutionized the cancer treatment with an approved efficacy in different solid tumors and hematologic malignancies. These agents are increasing the indication in cancer treatment, but can be associated with serious immune-related adverse effects (IRAEs). Dermatologic and gastrointestinal toxicities are the most common IRAE followed by endocrinopathies with a different time of occurrence. Rarely cases of gastrointestinal toxicities are observed almost 2 years after initiation of the therapy. In this review we focus on liver toxicity related to these immunotherapeutic agents for which the largest amount of safety data is available. The management of drug-induced liver toxicity is very complicated and in same cases may take a long period of time to be resolved. A prompt recognition of liver IRAEs and an appropriate management of this event, requiring close collaboration with other specialist figures, could improve its treatment with evident implication on the efficacy of the therapy.
免疫检查点抑制剂在不同的实体瘤和血液恶性肿瘤中已被证实具有疗效，从而彻底改变了癌症治疗。这些药物正在增加癌症治疗的适应证，但可能与严重的免疫相关不良事件（IRAEs）相关。皮肤毒性和胃肠道毒性是最常见的 IRAE，其次是内分泌疾病，其发生时间不同。罕见情况下，在开始治疗后近 2 年观察到胃肠道毒性。在本综述中，我们重点关注与这些免疫治疗药物相关的肝毒性，这些药物具有最大数量的安全性数据。药物性肝毒性的管理非常复杂，在某些情况下可能需要很长时间才能解决。及时识别肝 IRAEs 并对其进行适当的管理，需要与其他专家密切合作，这可以改善其治疗效果，对治疗效果有明显影响。
