Basek Aleksandra, Jakubiak Grzegorz K, Cieślar Grzegorz, Stanek Agata
Student Research Group, Department and Clinic of Internal Medicine, Angiology, and Physical Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Batorego 15 St., 41-902 Bytom, Poland.
Department and Clinic of Internal Medicine, Angiology, and Physical Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Batorego 15 St., 41-902 Bytom, Poland.
Cancers (Basel). 2023 Dec 10;15(24):5786. doi: 10.3390/cancers15245786.
Malignant neoplasms are currently one of the leading causes of morbidity and mortality worldwide, posing a major public health challenge. However, recent advances in research in cancer biology and immunity have led to the development of immunotherapy, which is now used on an everyday basis in cancer treatment in addition to surgical treatment, classical cytostatics, and radiotherapy. The efficacy of immunotherapy has promoted the great popularity of this treatment among patients, as well as significant research interest. The increasing number of patients being treated with immunotherapy not only reassures physicians of the efficacy of this technique but also shows the wide spectrum of side effects of this therapy, which has not been considered before. Immune-related adverse events may affect many systems and organs, such as digestive, cardiovascular, respiratory, skin, or endocrine organs. Most complications have a mild or moderate course, but there are life-threatening manifestations that are essential to be aware of because if they are not properly diagnosed and treated on time, they can have fatal consequences. The purpose of this paper was to present the results of a literature review on the current state of knowledge on life-threatening endocrine side effects (such as adrenal crisis, thyroid storm, myxoedema crisis, diabetic ketoacidosis, and severe hypocalcaemia) of immune checkpoint inhibitors to provide information on symptoms, diagnostics, and management strategies.
恶性肿瘤是目前全球发病和死亡的主要原因之一,构成了重大的公共卫生挑战。然而,癌症生物学和免疫研究的最新进展导致了免疫疗法的发展,目前除了手术治疗、传统细胞抑制剂和放射治疗外,免疫疗法在癌症治疗中每天都在使用。免疫疗法的疗效促进了这种治疗方法在患者中的广泛普及,也引发了大量的研究兴趣。接受免疫疗法治疗的患者数量不断增加,这不仅让医生对该技术的疗效放心,也显示出这种疗法广泛的副作用,而这些副作用以前并未得到重视。免疫相关不良事件可能会影响许多系统和器官,如消化、心血管、呼吸、皮肤或内分泌器官。大多数并发症病程较轻或中等,但存在危及生命的表现,必须予以关注,因为如果不能及时正确诊断和治疗,可能会产生致命后果。本文的目的是介绍关于免疫检查点抑制剂危及生命的内分泌副作用(如肾上腺危象、甲状腺风暴、黏液性水肿危象、糖尿病酮症酸中毒和严重低钙血症)的当前知识状态的文献综述结果,以提供有关症状、诊断和管理策略的信息。