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乳腺癌中免疫检查点抑制剂副作用的管理

Managing side effects of immune checkpoint inhibitors in breast cancer.

作者信息

Criscitiello Carmen, Corti Chiara, Pravettoni Gabriella, Curigliano Giuseppe

机构信息

Division of Early Drug Development for Innovative Therapy, European Institute of Oncology, IRCCS, Milan, Italy; Department of Oncology and Haematology (DIPO), University of Milan, Milan, Italy.

Division of Early Drug Development for Innovative Therapy, European Institute of Oncology, IRCCS, Milan, Italy; Department of Oncology and Haematology (DIPO), University of Milan, Milan, Italy.

出版信息

Crit Rev Oncol Hematol. 2021 Jun;162:103354. doi: 10.1016/j.critrevonc.2021.103354. Epub 2021 May 21.

Abstract

Immune-checkpoint inhibitors (ICIs) represent a major development in cancer therapy. The indications for these agents continue to expand across malignancies and disease settings. For years breast cancer (BC) has been considered immunologically quiescent compared with other tumor types. However, recent findings highlighted the immunogenicity of some BCs and paved the way for clinical trials of immunotherapy in BC that led to recent landmark approvals. As a drawback, the safety profile of ICIs is shaped by a specific spectrum of immune-related adverse events (irAEs) that can vary according to ICI class and tumor histology. This review will discuss the epidemiology of these adverse events, their kinetics, risk factors and the most important aspects in their management. A particular focus will be put on BC as the current landscape of immunotherapy for this disease is rapidly increasing the number of people treated with ICIs, thus susceptible to irAEs.

摘要

免疫检查点抑制剂(ICIs)是癌症治疗领域的一项重大进展。这些药物的适应证在各种恶性肿瘤和疾病背景下不断扩大。多年来,与其他肿瘤类型相比,乳腺癌(BC)一直被认为免疫原性较低。然而,最近的研究结果突出了某些乳腺癌的免疫原性,并为乳腺癌免疫治疗的临床试验铺平了道路,这些试验带来了近期具有里程碑意义的批准。作为一个缺点,ICI的安全性特征由特定范围的免疫相关不良事件(irAEs)决定,这些不良事件可能因ICI类别和肿瘤组织学而异。本综述将讨论这些不良事件的流行病学、其发生发展过程、危险因素以及管理中的最重要方面。将特别关注乳腺癌,因为目前该疾病的免疫治疗格局正在迅速增加接受ICI治疗的人数,因此易发生irAEs。

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