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免疫检查点抑制剂的皮肤超敏反应。

Cutaneous Hypersensitivity Reactions to Immune Checkpoint Inhibitors.

机构信息

Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY.

Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY.

出版信息

J Allergy Clin Immunol Pract. 2024 May;12(5):1132-1136. doi: 10.1016/j.jaip.2024.03.034. Epub 2024 Mar 26.

Abstract

The introduction of immune checkpoint inhibitors (ICIs) has transformed the management of various malignancies. Alongside their therapeutic success, the widespread application of ICIs has unveiled a spectrum of immune-related adverse events (irAEs), most often affecting the skin. Cutaneous irAEs (cirAEs) encompass a range from common morbilliform and lichenoid rashes to more severe conditions such as bullous dermatoses and psoriasiform eruptions, each presenting distinct clinical challenges. Moreover, less common but clinically severe cutaneous reactions like toxic epidermal necrolysis have also been observed. cirAEs are frequently observed, with an incidence ranging from 37% to 70% for anti-cytotoxic T lymphocyte-associated antigen-4 antibodies and 17% to 40% for anti- programmed death-1/anti-programmed death ligand-1 antibodies. Recognizing the critical need for effective therapeutic strategies, this review carefully examines current approaches and guidelines for managing cirAEs.

摘要

免疫检查点抑制剂(ICIs)的引入改变了各种恶性肿瘤的治疗管理模式。随着它们的广泛应用,ICI 引发了一系列免疫相关不良反应(irAEs),这些不良反应最常影响皮肤。皮肤免疫相关不良反应(cirAEs)包括从常见的麻疹样和苔藓样皮疹到更严重的情况,如大疱性皮肤病和银屑病样发作,每种情况都有不同的临床挑战。此外,还观察到毒性表皮坏死松解症等不太常见但临床严重的皮肤反应。cirAEs 很常见,抗细胞毒性 T 淋巴细胞相关抗原-4 抗体的发生率为 37%至 70%,抗程序性死亡-1/抗程序性死亡配体-1 抗体的发生率为 17%至 40%。鉴于对有效治疗策略的迫切需求,本综述仔细研究了目前管理 cirAEs 的方法和指南。

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