Suppr超能文献

免疫检查点抑制剂不良反应的管理

Management of the Adverse Effects of Immune Checkpoint Inhibitors.

作者信息

Morgado Manuel, Plácido Ana, Morgado Sandra, Roque Fátima

机构信息

Pharmaceutical Services of University Hospital Center of Cova da Beira, 6200-251 Covilhã, Portugal.

Research Unit for Inland Development, Polytechnic of Guarda (UDI-IPG), 6300-559 Guarda, Portugal.

出版信息

Vaccines (Basel). 2020 Oct 1;8(4):575. doi: 10.3390/vaccines8040575.

Abstract

By increasing the activity of the immune system, immune checkpoint inhibitors (ICPI) can have adverse inflammatory effects, which are referred to as immune-related adverse effects (irAEs). In this review, we present the recommendations for the appropriate identification and treatment of irAEs associated with ICPI to increase the safety and effectiveness of therapy with these immuno-oncological drugs. Several guidelines to manage irAEs adopted by different American and European societies in the field of oncology were identified. A narrative review of the several strategies adopted to manage irAEs was performed. With close clinical surveillance, ICPI can be used even in patients who have mild irAEs. Moderate to severe events require early detection and appropriate treatment, particularly in patients with a history of transplantation or pre-existing autoimmune disease. In most cases, adverse reactions can be treated with the interruption of treatment and/or supportive therapy, which includes, in serious adverse reactions, the administration of immunosuppressants. The identification and treatment of irAEs in the early stages may allow patients to resume therapy with ICPI. This review is an instrument to support healthcare professionals involved in the treatment and monitoring of patients who are administered ICPI, contributing to the timely identification and management of irAEs.

摘要

通过增强免疫系统的活性,免疫检查点抑制剂(ICPI)可能会产生不良炎症反应,即免疫相关不良反应(irAE)。在本综述中,我们提出了关于ICPI相关irAE的适当识别和治疗的建议,以提高这些免疫肿瘤药物治疗的安全性和有效性。我们确定了美国和欧洲肿瘤学领域不同学会采用的几种管理irAE的指南。对管理irAE所采用的几种策略进行了叙述性综述。通过密切的临床监测,即使是有轻度irAE的患者也可以使用ICPI。中度至重度事件需要早期检测和适当治疗,特别是对于有移植史或既往存在自身免疫性疾病的患者。在大多数情况下,不良反应可以通过中断治疗和/或支持性治疗来处理,在严重不良反应中,支持性治疗包括给予免疫抑制剂。早期识别和治疗irAE可能使患者能够恢复ICPI治疗。本综述是一种工具,可支持参与接受ICPI治疗患者的治疗和监测的医护人员,有助于及时识别和管理irAE。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd29/7711557/8f2284dab900/vaccines-08-00575-g001.jpg

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验