Department of Urology, Jena University Hospital, Jena, Germany.
Specialist Centre for Kidney Cancer, Royal Free London NHS Foundation Trust, London, UK; UCL Division of Surgery and Interventional Science, London, UK.
Eur Urol. 2019 Sep;76(3):368-380. doi: 10.1016/j.eururo.2019.05.041. Epub 2019 Jun 21.
Immune checkpoint inhibitors (ICIs) are now used routinely to treat advanced or metastatic urothelial and renal cell carcinoma, among other cancers. Furthermore, multiple trials are currently exploring their role in adjuvant, neoadjuvant, and noninvasive (eg, high-grade non-muscle-invasive bladder cancer) settings. Consequently, urologists are increasingly confronted with patients who are on, have recently received, or will be treated with ICI therapy. The care of these patients is likely to be shared between urologists and medical oncologists, with additional occasional support of other medical specialties. Therefore, it is important that urologists have good knowledge of immune-related side effects. Here, we provide advice on prevention, early diagnosis, and clinical management of the most relevant toxicities to strengthen urologists' insight and, thus, role in the multidisciplinary management in the new immunotherapy era. PATIENT SUMMARY: Immune therapy is a common treatment for many patients with advanced cancer. We describe common side effects of this treatment, and advise how they are best prevented and managed.
免疫检查点抑制剂 (ICIs) 目前已常规用于治疗晚期或转移性尿路上皮癌和肾细胞癌等多种癌症。此外，目前有多项试验正在探索其在辅助、新辅助和非侵入性（如高级别非肌肉浸润性膀胱癌）治疗中的作用。因此，泌尿科医生越来越多地面临正在接受、最近接受或将要接受 ICI 治疗的患者。这些患者的治疗可能由泌尿科医生和肿瘤内科医生共同负责，偶尔还需要其他医学专业的支持。因此，泌尿科医生必须具备良好的免疫相关副作用知识。在这里，我们提供有关最相关毒性的预防、早期诊断和临床管理的建议，以增强泌尿科医生的洞察力，从而在免疫治疗新时代发挥多学科管理的作用。
免疫治疗是许多晚期癌症患者的常见治疗方法。我们描述了这种治疗的常见副作用，并建议如何最好地预防和管理这些副作用。
