Ohwada Sae, Ishigami Keisuke, Akutsu Noriyuki, Nakase Hiroshi
Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Hokkaido 060-8556, Japan.
Biomedicines. 2022 Jun 6;10(6):1334. doi: 10.3390/biomedicines10061334.
Immune checkpoint inhibitor treatment has shown revolutionary therapeutic effects in various carcinomas. However, immune-related adverse events (irAE) following this treatment can sometimes lead to treatment discontinuation. One such frequently encountered adverse event is immune-related colitis (irAE colitis). Corticosteroids (CS) are the first-line treatment for irAE colitis, but we often encounter CS-refractory or -resistant cases. The application of multiple biologics has been proposed as a therapy to be administered after CS treatment; however, the efficacy and safety of biologics for patients with irAE colitis who do not respond to CS have not been established. This review summarizes the treatment regimens available for irAE colitis, focusing on the mechanism of action of corticosteroids, infliximab, vedolizumab, and other drugs.
免疫检查点抑制剂治疗已在多种癌症中显示出革命性的治疗效果。然而，这种治疗后的免疫相关不良事件（irAE）有时会导致治疗中断。免疫相关结肠炎（irAE 结肠炎）就是一种经常遇到的不良事件。皮质类固醇（CS）是 irAE 结肠炎的一线治疗药物，但我们经常遇到对 CS 难治或耐药的病例。已提出应用多种生物制剂作为 CS 治疗后的一种治疗方法；然而，对于对 CS 无反应的 irAE 结肠炎患者，生物制剂的疗效和安全性尚未确立。本综述总结了可用于 irAE 结肠炎的治疗方案，重点关注皮质类固醇、英夫利昔单抗、维多珠单抗和其他药物的作用机制。
