Bruera Sebastian, Suarez-Almazor Maria E
Section of Immunology, Allergy and Rheumatology, Baylor College of Medicine, Houston, TX, United States.
Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
Front Oncol. 2022 Aug 23;12:928390. doi: 10.3389/fonc.2022.928390. eCollection 2022.
The emergence of checkpoint inhibitors has created a paradigm shift for the treatment of various malignancies. However, although these therapies are associated with improved survival rates, they also carry the risk of immune-related adverse events (irAEs). Moderate to severe irAEs are typically treated with glucocorticoids, sometimes with the addition of immunosuppressants as steroid-sparing therapy. However, it is unclear how glucocorticoids and immunosuppressants may impact cancer survival and the efficacy of immune checkpoint therapy on cancer. In this narrative review, we discuss the effects of glucocorticoids and immunosuppressants including methotrexate, hydroxychloroquine, azathioprine, mycophenolate mofetil, tumor-necrosis factor (TNF)-inhibitors, interleukin-6 inhibitors, interleukin-1 inhibitors, abatacept, rituximab, and Janus kinase inhibitors (JAKi) on cancer-specific outcomes in the setting of immune checkpoint inhibitor use.
检查点抑制剂的出现为各种恶性肿瘤的治疗带来了范式转变。然而，尽管这些疗法与生存率提高相关，但它们也存在免疫相关不良事件（irAEs）的风险。中度至重度irAEs通常用糖皮质激素治疗，有时会加用免疫抑制剂作为类固醇节省疗法。然而，尚不清楚糖皮质激素和免疫抑制剂如何影响癌症生存率以及免疫检查点疗法对癌症的疗效。在这篇叙述性综述中，我们讨论了糖皮质激素和免疫抑制剂，包括甲氨蝶呤、羟氯喹、硫唑嘌呤、霉酚酸酯、肿瘤坏死因子（TNF）抑制剂、白细胞介素-6抑制剂、白细胞介素-1抑制剂、阿巴西普、利妥昔单抗和 Janus激酶抑制剂（JAKi）在使用免疫检查点抑制剂情况下对癌症特异性结局的影响。
