Hui Gavin, Drolen Claire, Hannigan Christopher A, Drakaki Alexandra
Department of Medicine, Stanford University, Stanford, CA 94305, USA.
Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA 90095, USA.
Life (Basel). 2022 Mar 2;12(3):360. doi: 10.3390/life12030360.
Numerous immunotherapeutic agents, such as immune checkpoint inhibitors (ICIs), have been approved for the treatment of genitourinary (GU) malignancies. While ICIs have improved treatment outcomes and expanded treatment options, they can cause immune-related adverse events (irAEs). The scope of irAEs is broad, and this paper aims to review the rheumatologic side effects associated with immunotherapy drugs approved for bladder cancer and renal cell carcinoma. IrAEs are graded by the common terminology criteria for adverse events (CTCAE), which ranges from 1 to 5. The management of irAEs includes corticosteroids or other immunosuppressive therapies, and it may require discontinuation of immunotherapy. Several real world experience studies suggest that most patients with pre-existing autoimmune diseases treated with ICI did not have to discontinue treatment due to immune-mediated side effects. While data suggest autoimmune side effects are manageable, patients with pre-existing autoimmune diseases are often excluded from immunotherapy clinical trials. Better understanding of these irAEs will improve its safety and expand its use in those with underlying autoimmune disease.
许多免疫治疗药物，如免疫检查点抑制剂（ICI），已被批准用于治疗泌尿生殖系统（GU）恶性肿瘤。虽然ICI改善了治疗效果并扩大了治疗选择，但它们可能会引起免疫相关不良事件（irAE）。irAE的范围很广，本文旨在综述与批准用于膀胱癌和肾细胞癌的免疫治疗药物相关的风湿性副作用。irAE根据不良事件通用术语标准（CTCAE）进行分级，范围从1到5。irAE的管理包括使用皮质类固醇或其他免疫抑制疗法，可能需要停止免疫治疗。一些真实世界经验研究表明，大多数接受ICI治疗的已有自身免疫性疾病的患者不必因免疫介导的副作用而停止治疗。虽然数据表明自身免疫性副作用是可控的，但已有自身免疫性疾病的患者通常被排除在免疫治疗临床试验之外。更好地了解这些irAE将提高其安全性，并扩大其在有潜在自身免疫性疾病患者中的应用。
