Shalit Almog, Sarantis Panagiotis, Koustas Evangelos, Trifylli Eleni-Myrto, Matthaios Dimitris, Karamouzis Michalis V
Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.
First Department of Internal Medicine, 417 Army Share Fund Hospital, 11521 Athens, Greece.
Cancers (Basel). 2023 Jan 6;15(2):375. doi: 10.3390/cancers15020375.
In recent years, in the context of the increase in the life expectancy of cancer patients, special attention has been given to immunotherapy and, indeed, to immune checkpoint inhibitors. The use of immune checkpoint inhibitors has increased rapidly, and approximately 40% of cancer patients are eligible for this treatment. Although their impact is valuable on cancer treatment, immune checkpoint inhibitors come with side effects, known as immune-related adverse effects. These can affect many systems, including cutaneous, musculoskeletal, cardiovascular, gastrointestinal, endocrine, neural, and pulmonary systems. In this review, we focus on immune-related endocrinopathies that affect around 10% of all treated patients. Endocrine dysfunctions can manifest as hypophysitis, thyroid dysfunction, hypoparathyroidism, insulin-deficient diabetes mellitus, and primary adrenal insufficiency. Currently, there are multiple ongoing clinical trials that aim to identify possible predictive biomarkers for immune-related adverse effects. The design of those clinical trials relies on collecting a variety of biological specimens (tissue biopsy, blood, plasma, saliva, and stool) at baseline and regular intervals during treatment. In this review, we present the predictive biomarkers (such as antibodies, hormones, cytokines, human leukocyte antigens, and eosinophils) that could potentially be utilized in clinical practice in order to predict adverse effects and manage them appropriately.
近年来,在癌症患者预期寿命增加的背景下,免疫疗法,尤其是免疫检查点抑制剂受到了特别关注。免疫检查点抑制剂的使用迅速增加,约40%的癌症患者适合这种治疗。尽管免疫检查点抑制剂对癌症治疗有重要作用,但它们也会带来副作用,即免疫相关不良反应。这些不良反应可影响多个系统,包括皮肤、肌肉骨骼、心血管、胃肠道、内分泌、神经和肺部系统。在本综述中,我们重点关注影响约10%接受治疗患者的免疫相关内分泌病变。内分泌功能障碍可表现为垂体炎、甲状腺功能障碍、甲状旁腺功能减退、胰岛素缺乏型糖尿病和原发性肾上腺皮质功能减退。目前,有多项正在进行的临床试验旨在确定免疫相关不良反应的可能预测生物标志物。这些临床试验的设计依赖于在基线时以及治疗期间定期收集各种生物标本(组织活检、血液、血浆、唾液和粪便)。在本综述中,我们介绍了可能在临床实践中用于预测不良反应并进行适当管理的预测生物标志物(如抗体、激素、细胞因子、人类白细胞抗原和嗜酸性粒细胞)。