Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807378, Taiwan.
Department of Dermatology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan.
Curr Oncol. 2023 Jul 18;30(7):6805-6819. doi: 10.3390/curroncol30070498.
Over the past few decades, immune checkpoint inhibitors (ICIs) have emerged as promising therapeutic options for the treatment of various cancers. These novel treatments effectively target key mediators of immune checkpoint pathways. Currently, ICIs primarily consist of monoclonal antibodies that specifically block cytotoxic T-lymphocyte antigen 4 (CTLA-4), programmed cell death 1 (PD-1), programmed cell death-ligand 1 (PD-L1), and lymphocyte activation gene 3 protein (LAG-3). Despite the notable efficacy of ICIs in cancer treatment, they can also trigger immune-related adverse events (irAEs), which present as autoimmune-like or inflammatory conditions. IrAEs have the potential to affect multiple organ systems, with cutaneous toxicities being the most commonly observed. Although cutaneous irAEs are typically of low-grade severity and can usually be managed effectively, there are cases where severe irAEs can become life-threatening. Therefore, early recognition and a comprehensive understanding of the mechanisms underlying cutaneous irAEs are crucial for improving clinical outcomes in cancer patients. However, the precise pathogenesis of cutaneous irAEs remains unclear. This review focuses on the skin manifestations induced by ICIs, the prognosis related to cutaneous irAEs, and the exploration of potential mechanisms involved in cutaneous irAEs.
在过去的几十年中，免疫检查点抑制剂（ICIs）已成为治疗各种癌症的有前途的治疗选择。这些新型治疗方法有效地靶向免疫检查点途径的关键介质。目前，ICI 主要由单克隆抗体组成，这些抗体特异性地阻断细胞毒性 T 淋巴细胞抗原 4（CTLA-4）、程序性细胞死亡 1（PD-1）、程序性细胞死亡配体 1（PD-L1）和淋巴细胞激活基因 3 蛋白（LAG-3）。尽管 ICI 在癌症治疗中具有显著的疗效，但它们也可能引发免疫相关的不良反应（irAEs），表现为自身免疫样或炎症状态。irAEs 有可能影响多个器官系统，皮肤毒性是最常见的观察结果。尽管皮肤 irAEs 通常为低级别严重程度，并且通常可以有效管理，但在某些情况下，严重的 irAEs 可能会危及生命。因此，早期识别和全面了解皮肤 irAEs 的机制对于改善癌症患者的临床结果至关重要。然而，皮肤 irAEs 的精确发病机制尚不清楚。本综述重点介绍了 ICI 引起的皮肤表现、与皮肤 irAEs 相关的预后以及对皮肤 irAEs 中涉及的潜在机制的探索。
