Song Young-Gi, Yoo Jeong-Ju, Kim Sang Gyune, Kim Young Seok
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Soonchunhyang University Hospital Bucheon, Soonchunhyang University College of Medicine, Bucheon, Korea.
J Liver Cancer. 2024 Mar;24(1):9-16. doi: 10.17998/jlc.2023.11.21. Epub 2023 Nov 29.
Immune checkpoint inhibitors (ICIs) are highly effective in cancer treatment. However, the risks associated with the treatment must be carefully balanced against the therapeutic benefits. Immune-related adverse events (irAEs) are generally unpredictable and may persist over an extended period. In this review, we analyzed common irAEs reported in highly cited original articles and systematic reviews. The prevalent adverse reactions include fatigue, pyrexia, rash, pruritus, diarrhea, decreased appetite, nausea, abdominal pain, constipation, hepatitis, and hypothyroidism. Therefore, it is crucial to conduct evaluations not only of gastrointestinal organs but also of cardiac, neurologic, endocrine (including the frequently affected thyroid), and ophthalmic systems before commencing ICIs. This review further explores commonly reported types of irAEs, specific irAEs associated with each ICI agent, rare yet potentially fatal irAEs, and available treatment options for managing them.
免疫检查点抑制剂（ICI）在癌症治疗中非常有效。然而，治疗相关风险必须与治疗益处仔细权衡。免疫相关不良事件（irAE）通常不可预测，且可能持续较长时间。在本综述中，我们分析了高被引原创文章和系统评价中报道的常见irAE。常见不良反应包括疲劳、发热、皮疹、瘙痒、腹泻、食欲减退、恶心、腹痛、便秘、肝炎和甲状腺功能减退。因此，在开始ICI治疗前，不仅要对胃肠道器官进行评估，还要对心脏、神经、内分泌（包括经常受累的甲状腺）和眼科系统进行评估。本综述进一步探讨了常见的irAE类型、每种ICI药物相关的特定irAE、罕见但可能致命的irAE以及针对这些情况的可用治疗方案。
