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免疫治疗介导的腔道胃肠道毒性。

Immunotherapy-Mediated Luminal Gastrointestinal Toxicities.

机构信息

Department of Gastroenterology, Hepatology & Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

出版信息

Adv Exp Med Biol. 2021;1342:331-337. doi: 10.1007/978-3-030-79308-1_12.

Abstract

The advent of immune checkpoint blockade and its application in the management of advanced malignancies has revolutionized cancer therapies, outcomes, and survival. As beneficial as these class of drugs have been proven to be, their use is not devoid of complications, viz., immune-related adverse events (irAEs). The gastrointestinal (GI) tract is the second most frequently affected organ system, and toxicities may vary in severity from mild disease to aggressive life-threatening clinical presentations. Timely diagnosis that incorporates clinical, biochemical, imaging, endoscopic, and histologic evaluation is imperative for efficacious management of this disease process to ensure good outcomes. Management varies depending on severity and can comprise supportive care in milder disease patterns as well as vigorous immunosuppression in aggressive cases.

摘要

免疫检查点阻断的出现及其在晚期恶性肿瘤治疗中的应用改变了癌症治疗、结果和生存。虽然这些药物已被证明是有益的,但它们的使用并非没有并发症,即免疫相关不良反应(irAEs)。胃肠道(GI)是第二大常受影响的器官系统,毒性的严重程度从轻度疾病到侵袭性危及生命的临床表现不等。及时诊断,包括临床、生化、影像学、内镜和组织学评估,对于有效管理这一疾病过程以确保良好的结果至关重要。管理取决于严重程度,可以包括轻度疾病模式的支持性护理以及侵袭性病例的强烈免疫抑制。

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