Ardolino Luke, Joshua Anthony
St Vincent's Hospital, Sydney.
St Vincent's Clinical School, UNSW Sydney.
Aust Prescr. 2019 Apr;42(2):62-67. doi: 10.18773/austprescr.2019.012. Epub 2019 Apr 1.
Immune checkpoints normally stop the body from mounting an immune response against healthy cells. Some cancers can acquire these checkpoints so that the tumour cells are not recognised by the immune system Inhibiting the checkpoints therefore enables the tumour cells to be recognised and allows an immune response to be activated against them Immune checkpoint inhibitors can improve the survival of some patients with advanced malignancies. These include malignant melanoma, renal cell carcinoma, urothelial bladder cancer and non-small cell lung cancer Trials have shown that immune checkpoint inhibitors have significant benefits over conventional therapies so they are increasingly being used in routine clinical practice However, a significant proportion of patients will not respond to immune checkpoint inhibitors and retain a poor prognosis. The optimal use of these drugs requires further study Immune-related adverse events commonly include pneumonitis, hepatitis, nephritis, colitis and endocrinopathies. However, nearly any organ system can be affected. These toxicities present clinicians with a new challenge of recognising them early and acting promptly
免疫检查点通常会阻止身体对健康细胞发起免疫反应。一些癌症会获得这些检查点，从而使肿瘤细胞不被免疫系统识别。因此，抑制这些检查点能够使肿瘤细胞被识别，并激活针对它们的免疫反应。免疫检查点抑制剂可以提高一些晚期恶性肿瘤患者的生存率。这些肿瘤包括恶性黑色素瘤、肾细胞癌、尿路上皮膀胱癌和非小细胞肺癌。试验表明，免疫检查点抑制剂比传统疗法有显著优势，因此它们越来越多地被用于常规临床实践。然而，相当一部分患者对免疫检查点抑制剂没有反应，预后仍然很差。这些药物的最佳使用方法需要进一步研究。免疫相关不良事件通常包括肺炎、肝炎、肾炎、结肠炎和内分泌病。然而，几乎任何器官系统都可能受到影响。这些毒性给临床医生带来了新的挑战，即要尽早识别并迅速采取行动。
