Department of Gastroenterology, Kanagawa Cancer Center, Yokohama, Japan.
Jpn J Clin Oncol. 2024 Sep 4;54(9):949-958. doi: 10.1093/jjco/hyae067.
Immune checkpoint inhibitors have revolutionized cancer treatment by targeting the cytotoxic T lymphocyte antigen-4 and programmed death-1/ligand-1. Although immune checkpoint inhibitors show promising therapeutic efficacy, they often cause immune-related adverse events. Immune-related adverse events differ from the side effects of conventional chemotherapy and require vigilant monitoring. These events predominantly affect organs, such as the colon, liver, lungs, pituitary gland, thyroid and skin, with rare cases affecting the heart, nervous system and other tissues. As immune-related adverse events result from immune activation, indicating the reinvigoration of exhausted immune cells that attack both tumors and normal tissues, it is theoretically possible that immune-related adverse events may signal a better response to immune checkpoint inhibitor therapy. Recent retrospective studies have explored the link between immune-related adverse event development and clinical efficacy; however, the predictive value of immune-related adverse events in the immune checkpoint inhibitor response remains unclear. Additionally, studies have focused on immune-related adverse events, timing of onset and immunosuppressive treatments. This review focuses on pivotal studies of the association between immune-related adverse events and outcomes in patients treated with immune checkpoint inhibitors.
免疫检查点抑制剂通过靶向细胞毒性 T 淋巴细胞抗原-4 和程序性死亡受体-1/配体-1,彻底改变了癌症治疗。虽然免疫检查点抑制剂显示出有前景的治疗效果,但它们经常引起免疫相关的不良反应。免疫相关的不良反应与传统化疗的副作用不同,需要警惕监测。这些事件主要影响器官,如结肠、肝脏、肺、垂体、甲状腺和皮肤,很少影响心脏、神经系统和其他组织。由于免疫相关的不良反应是由免疫激活引起的,表明衰竭的免疫细胞被重新激活,攻击肿瘤和正常组织,从理论上讲,免疫相关的不良反应可能表明对免疫检查点抑制剂治疗有更好的反应。最近的回顾性研究探讨了免疫相关不良反应的发生与临床疗效之间的联系;然而,免疫相关不良反应在免疫检查点抑制剂反应中的预测价值仍不清楚。此外,研究主要集中在免疫相关不良反应、发病时间和免疫抑制治疗上。这篇综述重点介绍了免疫检查点抑制剂治疗患者中免疫相关不良反应与结局之间的关联的关键研究。