Department of Autoimmune Diseases, ICMiD, Barcelona, Spain.
Laboratory of Autoimmune Diseases Josep Font, IDIBAPS-CELLEX, Barcelona, Spain.
Nat Rev Dis Primers. 2020 May 7;6(1):38. doi: 10.1038/s41572-020-0160-6.
Cancer immunotherapies have changed the landscape of cancer treatment during the past few decades. Among them, immune checkpoint inhibitors, which target PD-1, PD-L1 and CTLA-4, are increasingly used for certain cancers; however, this increased use has resulted in increased reports of immune-related adverse events (irAEs). These irAEs are unique and are different to those of traditional cancer therapies, and typically have a delayed onset and prolonged duration. IrAEs can involve any organ or system. These effects are frequently low grade and are treatable and reversible; however, some adverse effects can be severe and lead to permanent disorders. Management is primarily based on corticosteroids and other immunomodulatory agents, which should be prescribed carefully to reduce the potential of short-term and long-term complications. Thoughtful management of irAEs is important in optimizing quality of life and long-term outcomes.
在过去的几十年中,癌症免疫疗法改变了癌症治疗的格局。其中,针对 PD-1、PD-L1 和 CTLA-4 的免疫检查点抑制剂越来越多地用于某些癌症;然而,这种使用的增加导致了免疫相关不良事件 (irAE) 的报告增加。这些 irAE 是独特的,与传统癌症治疗不同,通常发病较晚,持续时间较长。irAE 可涉及任何器官或系统。这些影响通常是轻度的,可治疗且可逆转;然而,一些不良反应可能很严重,并导致永久性疾病。管理主要基于皮质类固醇和其他免疫调节剂,应谨慎处方以减少短期和长期并发症的潜在风险。irAE 的深思熟虑的管理对于优化生活质量和长期结果非常重要。