Tan Bei, Li Yue, Xu Yan, Chen Minjiang, Wang Mengzhao, Qian Jiaming
Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing, China.
Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing, China.
Asia Pac J Clin Oncol. 2020 Jun;16(3):95-102. doi: 10.1111/ajco.13317. Epub 2020 Feb 20.
Immunotherapy is revolutionizing the treatment paradigm for a broad spectrum of malignancies. However, the immune checkpoint inhibitors also cause a unique set of toxicities. In the digestive system, this has consisted for the most part as colitis and hepatotoxicity, but also include less-common manifestations. Baseline screening, early identification, timely diagnosis, rapid and adequate treatment can significantly minimize the toxicity of immunotherapy and improve prognosis. This article provides a comprehensive review of gastrointestinal and hepatic immune-related toxicities, including incidence, mechanism, clinical manifestation, diagnosis, treatment, and guidelines for resumption of immune checkpoint inhibitor therapy.
免疫疗法正在彻底改变多种恶性肿瘤的治疗模式。然而，免疫检查点抑制剂也会引发一系列独特的毒性反应。在消化系统中，这主要表现为结肠炎和肝毒性，但也包括一些不太常见的表现。基线筛查、早期识别、及时诊断、快速且充分的治疗可显著降低免疫疗法的毒性并改善预后。本文全面综述了胃肠道和肝脏免疫相关毒性，包括发病率、机制、临床表现、诊断、治疗以及免疫检查点抑制剂治疗恢复的指南。
