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胃肠道不良事件。

Gastrointestinal Tract Adverse Events.

机构信息

Department of Internal Medicine, University of Missouri, Kansas City, MO, USA.

Department of Gastroenterology, Hepatology & Nutrition, University of Texas MD Anderson Cancer Center, Houston, TX, USA.

出版信息

Adv Exp Med Biol. 2020;1244:247-253. doi: 10.1007/978-3-030-41008-7_12.

Abstract

Immune checkpoint inhibitors (ICIs) have shown significant benefit in cancer patients. Their success, however, is associated with immune-related adverse events (irAEs), which commonly affect the gastrointestinal tract, resulting in diarrhea and colitis. IrAEs range from mild self-limiting to severe life-threatening diseases and potentially limit the use of these medications. Diagnosis of ICI-induced enterocolitis is based on clinical symptoms, physical examination, stool tests, endoscopic and histologic evaluation, and/or imaging. Current management strategy is mainly anti-diarrheal agents for mild symptoms and immunosuppressants (e.g., corticosteroids, and infliximab or vedolizumab) for more severe diseases.

摘要

免疫检查点抑制剂(ICIs)在癌症患者中显示出显著的疗效。然而,它们的成功与免疫相关的不良反应(irAEs)有关,这些不良反应通常会影响胃肠道,导致腹泻和结肠炎。irAEs 从轻到重不等,从自限性到危及生命的疾病都有,并且可能限制这些药物的使用。ICI 诱导性肠炎的诊断基于临床症状、体检、粪便检查、内镜和组织学评估和/或影像学检查。目前的治疗策略主要是针对轻度症状的抗腹泻药物和免疫抑制剂(如皮质类固醇、英夫利昔单抗或维得利珠单抗)治疗更严重的疾病。

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