Fiala O, Šorejs O, Šustr J, Fínek J
Klin Onkol. 2020 Winter;33(1):8-10. doi: 10.14735/amko20208.
Modern immunotherapy based on immune checkpoint inhibitors is an innovative treatment, which is already used in the treatment of a number of malignancies, and many other checkpoint inhibitors have been investigated in clinical trials. Monoclonal antibodies against CTLA-4 (cytotoxic T-lymphocyte antigen-4) and PD-1 (programmed cell death-1) or PD-L1 (programmed cell death-1 ligand) are the most commonly used agents. The side effects of these treatments are similar in nature to those of autoimmune diseases. Recently, increasing evidence has indicated that some adverse effects of immunotherapy are associated with the beneficial effect of this treatment.
The aim of this review was to summarize current knowledge of the association between the adverse effects of checkpoint inhibitors and the outcomes of patients treated with this therapy.
The association between the effect of immunotherapy and the occurrence of adverse reactions has been identified in a number of studies. It has been best documented in patients with malignant melanoma, non-small cell lung cancer, and renal cell carcinoma. Many studies published so far are limited by the relatively low number of patients and their retrospective design, leaving many questions still unanswered. This work was supported by the National Sustainability Program I (NPU I) Nr. LO1503 provided by the Ministry of Education Youth and Sports of the Czech Republic and by the Charles University Research Fund (Progres Q39) and by the European Regional Development Fund-Project „Application of Modern Technologies in Medicine and Industry” (No. CZ.02.1.01/0.0/0.0/17_048/0007280). The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers. Submitted: 3. 11. 2019 Accepted: 8. 12. 2019.
基于免疫检查点抑制剂的现代免疫疗法是一种创新疗法,已用于多种恶性肿瘤的治疗,并且许多其他检查点抑制剂正在临床试验中进行研究。抗细胞毒性T淋巴细胞相关抗原4(CTLA-4)、程序性死亡蛋白1(PD-1)或程序性死亡蛋白1配体(PD-L1)的单克隆抗体是最常用的药物。这些治疗的副作用在本质上与自身免疫性疾病的副作用相似。最近,越来越多的证据表明免疫疗法的一些不良反应与这种治疗的有益效果相关。
本综述的目的是总结目前关于检查点抑制剂的不良反应与接受该疗法治疗的患者结局之间关联的知识。
免疫疗法的效果与不良反应发生之间的关联已在多项研究中得到证实。在恶性黑色素瘤、非小细胞肺癌和肾细胞癌患者中记录最为充分。迄今为止发表的许多研究受患者数量相对较少及其回顾性设计的限制,仍有许多问题未得到解答。本研究得到了捷克共和国教育、青年和体育部提供的国家可持续发展计划I(NPU I)编号LO1503、查理大学研究基金(Progres Q39)以及欧洲区域发展基金项目“现代技术在医学和工业中的应用”(编号CZ.02.1.01/0.0/0.0/17_048/0007280)的支持。作者声明他们在研究中使用的药物、产品或服务方面没有潜在的利益冲突。编辑委员会声明该手稿符合国际医学期刊编辑委员会(ICMJE)对生物医学论文的建议。提交日期:2019年11月3日;接受日期:2019年12月8日。