Lazarou Ilias, Fernandez Eugenio
Service de rhumatologie, Département de médecine, HUG, Avenue de Beau-Séjour 26, 1206 Genève.
Service d'oncologie, Département d'oncologie, HUG, 1211 Genève 14.
Rev Med Suisse. 2020 Mar 11;16(685):504-507.
Cancer management has been revolutionised by immune checkpoint inhibitors. Their use and indications increase in parallel with the recognition of their various side effects. Arthritis, myositis, and vasculitis are among the most common rheumatologic immune-related adverse events (irAE) of immunotherapy. Rheumatological irAEs can be of late onset, occur even after the cessation of the culprit drug and persist into time. In this article we discuss the principles of cancer immunotherapy, clinical manifestations and management of the most common rheumatologic irAEs, and aspects of immune checkpoint inhibitors therapy in patients with pre-existing autoimmune disease.
免疫检查点抑制剂彻底改变了癌症治疗方式。随着人们对其各种副作用的认识不断加深,其使用和适应证也在增加。关节炎、肌炎和血管炎是免疫治疗中最常见的风湿性免疫相关不良事件(irAE)。风湿性irAE可能起病较晚,甚至在停用致病药物后仍会出现,并会持续一段时间。在本文中,我们讨论了癌症免疫治疗的原则、最常见的风湿性irAE的临床表现和管理,以及已有自身免疫性疾病患者的免疫检查点抑制剂治疗的相关方面。