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肿瘤免疫治疗相关不良反应:全科医学临床实践指导。

Immune-related adverse events secondary to immunotherapy in oncology: A guide for general practice.

机构信息

MBBS(Hons), BMedSc(Hons), Medical Oncology Clinical Trials Fellow, Department of Medical Oncology, Alfred Hospital, Melbourne, Vic; Clinical Bedside Tutor, Central Clinical School, Monash University, Melbourne, Vic.

MBBS(Hons), BMedSc(Hons), DRANZCOG, MScRSHR, FRACGP, Academic GP Registrar, Monash University, Melbourne, Vic.

出版信息

Aust J Gen Pract. 2023 Jun;52(6):378-385. doi: 10.31128/AJGP-04-22-6408.

Abstract

BACKGROUND

Immunotherapy has reshaped the prognoses for many cancers and is increasingly used in both metastatic and adjuvant settings. There is a high prevalence of immunotherapy side effects, or immune-related adverse events (irAEs), which can affect any organ. Some irAEs can cause permanent or prolonged morbidity and, in rare cases, may be fatal. irAEs can present with mild, non-specific symptoms, resulting in delays to identification and management.

OBJECTIVE

We aim to provide a general overview of immunotherapy and irAEs, highlighting common clinical scenarios and general principles of management.

DISCUSSION

Cancer immunotherapy toxicity is an important clinical problem that is increasingly relevant to general practice, where patients with adverse events may first present. Early diagnosis and timely intervention are important in limiting the severity and morbidity of these toxicities. The management of irAEs should follow treatment guidelines, in consultation with patients' treating oncology teams.

摘要

背景

免疫疗法改变了许多癌症的预后,并且越来越多地用于转移性和辅助治疗环境中。免疫疗法的副作用(irAEs)或免疫相关不良事件的发生率很高,可能影响任何器官。一些 irAEs 可导致永久性或长期性发病率,在极少数情况下,可能是致命的。irAEs 可表现为轻度、非特异性症状,导致识别和管理延迟。

目的

我们旨在提供免疫疗法和 irAEs 的概述,重点介绍常见的临床情况和一般管理原则。

讨论

癌症免疫疗法毒性是一个重要的临床问题,越来越与普通实践相关,其中可能首先出现不良事件的患者。早期诊断和及时干预对于限制这些毒性的严重程度和发病率非常重要。irAEs 的管理应遵循治疗指南,并与患者的肿瘤治疗团队协商。

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