患有潜在自身免疫性疾病的黑色素瘤患者中的检查点抑制剂
Checkpoint Inhibitors in Melanoma Patients with Underlying Autoimmune Disease.
作者信息
Dietz Hilary, Weinmann Sophia C, Salama April K
机构信息
Division of Medical Oncology, Duke University, Durham, NC, USA.
Division of Rheumatology and Immunology, Duke University, Durham, NC, USA.
出版信息
Cancer Manag Res. 2021 Nov 2;13:8199-8208. doi: 10.2147/CMAR.S283217. eCollection 2021.
Abstract
The development of immune checkpoint inhibitors (ICI) has dramatically changed the clinical management of metastatic melanoma and other solid tumors. Despite exclusion from initial clinical trials, there is a growing body of retrospective data that suggest ICI can be used in patients with underlying autoimmune disease (AID) with a tolerable level of anticipated immune-related adverse events (irAEs) and a rate of severe irAEs comparable to that of patients without underlying AID. Coordination with other subspecialists and careful monitoring for irAEs is critical in safely managing these patients. Studies exploring novel approaches examining the use of targeted immunosuppressants in the prevention and management of irAEs, as well as multiple studies currently underway are aimed at establishing safe clinical practices when using ICI in patients with underlying AID.
摘要
免疫检查点抑制剂（ICI）的发展极大地改变了转移性黑色素瘤和其他实体瘤的临床管理。尽管最初的临床试验将其排除在外，但越来越多的回顾性数据表明，ICI可用于患有自身免疫性疾病（AID）的患者，其预期的免疫相关不良事件（irAE）水平可耐受，且严重irAE的发生率与无潜在AID的患者相当。与其他专科医生协作并仔细监测irAE对于安全管理这些患者至关重要。探索使用靶向免疫抑制剂预防和管理irAE的新方法的研究，以及目前正在进行的多项研究，旨在确立在患有潜在AID的患者中使用ICI时的安全临床实践。
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