Liu Yu, Wang Hao, Deng Juan, Sun Chenglong, He Yayi, Zhou Caicun
Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute, Tongji University School of Medicine, Shanghai 200433, China.
Tongji University, Shanghai 200433, China.
Transl Lung Cancer Res. 2019 Dec;8(6):1125-1133. doi: 10.21037/tlcr.2019.11.26.
In recent years, immunotherapy, especially immune checkpoint inhibitors (ICIs), has achieved amazing results in the treatment of lung cancer, melanoma, renal clear cell carcinoma and other malignant tumors. Although ICIs have achieved significant efficacy in tumor treatment, the immune-related adverse events (irAEs) caused by non-specific immune activation of ICIs can directly affect the result of treatment, even threaten the life of patients. The most common form of irAEs involve the skin, lung, colon, liver and endocrine organs. However, it is noticeable that although irAEs of some organs are more common, actually any organ and tissue are likely to be affected, because of non-specific activation of the immune system. Other tissues and organs, though rare, can be more severe and even fatal, such as neurological disorders and myocarditis. Therefore, effective management of irAEs is of great importance for the efficacy of immunotherapy. This review is focused on the morbidity, clinical manifestations, diagnosis and treatment of tumor immune toxic effects.
近年来，免疫疗法，尤其是免疫检查点抑制剂（ICIs），在肺癌、黑色素瘤、肾透明细胞癌等恶性肿瘤的治疗中取得了惊人的效果。尽管ICIs在肿瘤治疗中取得了显著疗效，但由ICIs非特异性免疫激活引起的免疫相关不良事件（irAEs）可直接影响治疗结果，甚至威胁患者生命。irAEs最常见的形式累及皮肤、肺、结肠、肝脏和内分泌器官。然而，值得注意的是，尽管某些器官的irAEs更为常见，但由于免疫系统的非特异性激活，实际上任何器官和组织都可能受到影响。其他组织和器官虽然罕见，但可能更严重甚至致命，如神经紊乱和心肌炎。因此，有效管理irAEs对免疫治疗的疗效至关重要。本综述聚焦于肿瘤免疫毒性效应的发病率、临床表现、诊断和治疗。
