Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain.
H120-CNIO Lung Cancer Unit, Hospital Universitario 12 de Octubre, Universidad Complutense and Ciberonc, Madrid, Spain.
Expert Opin Drug Saf. 2020 Mar;19(3):233-242. doi: 10.1080/14740338.2020.1736554.
: Lung cancer is the leading cancer-related cause of death worldwide. The introduction of immune checkpoint inhibitors (ICIs) for the treatment of lung cancer has significantly improved the outcome of these patients. Pembrolizumab, a monoclonal IgG4-kappa antibody against programmed-death-1 (PD-1) protein, nowadays represents a standard of care for NSCLC patients. Although it has a favorable toxicity profile, some immune-related adverse events (irAEs) can be life-threatening, therefore its knowledge may help to optimize the care of these patients.: The authors review data regarding the efficacy and safety of pembrolizumab from the most relevant clinical trials as well as toxicities reported in the clinical use. Special considerations of use in special populations will be noted. Finally, its toxicity profile will be compared with other ICIs used in NSCLC.: In the scenario of NSCLC, pembrolizumab shows a favorable safety profile with less than 10% serious immune-related adverse events (irAEs) when used in monotherapy and without adding relevant extra-toxicity to chemotherapy when used in combination. Monotherapy with pembrolizumab is associated with better health-related quality of life than chemotherapy. Early recognition and appropriate treatment of irAEs is of prime importance as most are reversible if correctly managed. Rechallenge with pembrolizumab is frequently feasible.
肺癌是全球癌症相关死亡的主要原因。免疫检查点抑制剂（ICIs）的引入用于治疗肺癌，显著改善了这些患者的预后。帕博利珠单抗（pembrolizumab）是一种针对程序性死亡受体-1（PD-1）蛋白的单克隆 IgG4-κ 抗体，现已成为非小细胞肺癌（NSCLC）患者的标准治疗方法。虽然它具有良好的毒性特征，但一些免疫相关不良事件（irAEs）可能危及生命，因此了解这些不良事件可能有助于优化这些患者的治疗。
作者回顾了来自最相关临床试验的关于 pembrolizumab 的疗效和安全性的数据，以及在临床使用中报告的毒性。将特别注意在特殊人群中的使用。最后，将其毒性特征与 NSCLC 中使用的其他 ICI 进行比较。
在非小细胞肺癌的情况下，pembrolizumab 在单药治疗中严重免疫相关不良事件（irAEs）发生率低于 10%，与化疗联合使用时不会增加额外的毒性，因此具有良好的安全性。与化疗相比，pembrolizumab 单药治疗与更好的健康相关生活质量相关。早期识别和适当治疗 irAEs 至关重要，因为如果正确管理，大多数 irAEs 是可逆的。pembrolizumab 的再次用药通常是可行的。
