对于患有自身免疫性疾病的癌症患者，我们应该害怕免疫检查点抑制剂吗？自身免疫性疾病中的免疫疗法。
Should we be Afraid of Immune Check Point Inhibitors in Cancer Patients with Pre-Existing Rheumatic Diseases? Immunotherapy in Pre-Existing Rheumatic Diseases.
作者信息
Klavdianou Kalliopi, Melissaropoulos Konstantinos, Filippopoulou Alexandra, Daoussis Dimitrios
机构信息
Department of Rheumatology, "Asklepieion" General Hospital, Athens, Greece.
Department of Rheumatology, Agios Andreas Hospital, Patras, Greece.
出版信息
Mediterr J Rheumatol. 2021 Sep 30;32(3):218-226. doi: 10.31138/mjr.32.3.218. eCollection 2021 Sep.
BACKGROUND
Cancer immunotherapy is rapidly expanding but its clinical efficacy is hampered by immune related adverse events (ir-AE). There is a concern regarding patients with pre-existing auto-immune diseases (PAD) undergoing immunotherapy.
METHODS
An electronic search was performed (Medline) to identify cases of patients with PAD treated with immune checkpoint inhibitors (ICI).
RESULTS
Published data are rather limited but continue to emerge. Patients with PAD exhibit a high risk of PAD flare and/or de novo ir-AE. In most cases PAD flares and de novo irAEs were not severe and could be managed effectively with standard treatment.
CONCLUSIONS
This risk in patients with PAD appears acceptable, and therefore, these patients could receive immunotherapy under close monitoring. Collaboration of oncologists and rheumatologists for the management of these patients is crucial.
背景
癌症免疫疗法正在迅速发展，但其临床疗效受到免疫相关不良事件（ir-AE）的阻碍。对于患有自身免疫性疾病（PAD）的患者接受免疫疗法存在担忧。
方法
进行了电子检索（Medline）以识别接受免疫检查点抑制剂（ICI）治疗的PAD患者病例。
结果
已发表的数据相当有限，但仍在不断涌现。PAD患者出现PAD病情复发和/或新发ir-AE的风险较高。在大多数情况下，PAD病情复发和新发ir-AE并不严重，可以通过标准治疗有效管理。
结论
PAD患者的这种风险似乎是可以接受的，因此，这些患者可以在密切监测下接受免疫疗法。肿瘤学家和风湿病学家合作管理这些患者至关重要。
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