Wang Anqi, Xu Yan, Fei Yunyun, Wang Mengzhao
Department of Rheumatology and Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Asia Pac J Clin Oncol. 2020 Aug;16(4):201-210. doi: 10.1111/ajco.13332. Epub 2020 Mar 24.
The advent of immune checkpoint inhibitors has improved survival in some types of cancer and brought promising prospects to cancer immunotherapy. Despite their clinical benefits, significant off-target toxicities resulting from the immune system activation have been observed, namely immune-related adverse events (irAEs), which pose to clinicians a new challenge of optimal management. With steroids being the mainstay of current management of irAEs, immunosuppressive agents are especially indicated for severe or steroid-refractory cases, based on current immunopathophysiological knowledge and on extrapolations of treatment options for primary autoimmune disorders. This review focuses on the status and recent clinical progress of immunosuppressive agents in the management of severe and steroid-refractory irAEs.
免疫检查点抑制剂的出现提高了某些类型癌症的生存率，并为癌症免疫治疗带来了广阔前景。尽管它们具有临床益处，但已观察到免疫系统激活导致的显著脱靶毒性，即免疫相关不良事件（irAEs），这给临床医生带来了优化管理的新挑战。基于当前的免疫病理生理学知识以及对原发性自身免疫性疾病治疗选择的推断，类固醇是目前irAEs管理的主要手段，免疫抑制剂尤其适用于严重或类固醇难治性病例。本综述重点关注免疫抑制剂在严重和类固醇难治性irAEs管理中的现状和近期临床进展。
