Connolly Caoilfhionn, Bambhania Kalindi, Naidoo Jarushka
Department of Internal Medicine, Johns Hopkins Hospital, Baltimore, MD, United States.
Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD, United States.
Front Oncol. 2019 Jun 20;9:530. doi: 10.3389/fonc.2019.00530. eCollection 2019.
Immunotherapy has heralded the advent of a new era in oncology. Immune checkpoint inhibitors (ICIs) enhance anti-tumor immunity, thereby reinvigorating a patient's immune system to fight cancer. While therapy with this class of agents has resulted in improved clinical outcomes for patients with multiple tumor types, a broad spectrum of immune-related adverse events (irAEs) may affect any organ system, with variable clinical presentations. Prompt recognition and management of irAEs are associated with improved irAE outcomes, and represents an important new clinical challenge for practicing oncologists. Herein, we provide a comprehensive case-based review of the most common and clinically-important irAEs, focussing on epidemiology, clinical manifestations, and management. We also examine future strategies that may provide meaningful insights into the prevention and management of irAEs.
免疫疗法开创了肿瘤学的新纪元。免疫检查点抑制剂(ICIs)可增强抗肿瘤免疫力,从而重振患者的免疫系统以对抗癌症。虽然这类药物治疗已使多种肿瘤类型患者的临床结局得到改善,但广泛的免疫相关不良事件(irAEs)可能会影响任何器官系统,临床表现各异。及时识别和处理irAEs与改善irAEs结局相关,这对肿瘤学执业医师来说是一项重要的新临床挑战。在此,我们基于病例对最常见且具有临床重要性的irAEs进行全面综述,重点关注其流行病学、临床表现和处理。我们还探讨了可能为irAEs的预防和处理提供有意义见解的未来策略。