Barber Fedricker Diane
Department of Investigational Cancer Therapeutics (A Phase I Program), University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Asia Pac J Oncol Nurs. 2019 Jul-Sep;6(3):212-226. doi: 10.4103/apjon.apjon_6_19.
Over the past two decades, immunotherapy has emerged as a promising treatment option for patients with cancer. However, newer versions of immunotherapy, such as checkpoint inhibitors, may be associated with unusual adverse effects (AEs) that can range in severity from mild to life-threatening. Unlike common AEs of conventional chemotherapy, which have a predictable nadir or cyclic pattern after administration, AEs of these newer immunotherapies are variable, depending on the type of immunotherapy, route of administration, and mechanism of action. The onset and resolution of these AEs may be present at any time, during administration of treatment, a few weeks after administration of treatment, or several months after completion of treatment. Therefore, improving outcomes in patients undergoing oncologic immunotherapy requires oncology nurses' knowledge and understanding of various immunotherapy agents, as well as early recognition and management of potential AEs, especially AEs associated with checkpoint inhibitors and other therapies that manipulate T-cell activation causing autoimmune toxicity. This article draws upon current evidence from systematic reviews, meta-analyses, and expert consensus guidelines to provide a brief overview of common immunotherapies used in cancer and management of their associated AEs.
在过去二十年中,免疫疗法已成为癌症患者一种有前景的治疗选择。然而,更新版本的免疫疗法,如检查点抑制剂,可能会伴有不同寻常的不良反应(AE),其严重程度从轻到危及生命不等。与传统化疗的常见不良反应不同,传统化疗在给药后有可预测的最低点或周期性模式,而这些更新的免疫疗法的不良反应则各不相同,这取决于免疫疗法的类型、给药途径和作用机制。这些不良反应的发生和消退可能在治疗期间的任何时候、给药后几周或治疗完成后几个月出现。因此,改善接受肿瘤免疫治疗患者的治疗效果需要肿瘤护理人员了解和认识各种免疫治疗药物,以及对潜在不良反应的早期识别和管理,特别是与检查点抑制剂和其他操纵T细胞激活导致自身免疫毒性的疗法相关的不良反应。本文借鉴系统评价、荟萃分析和专家共识指南中的现有证据,简要概述了癌症中常用的免疫疗法及其相关不良反应的管理。