免疫检查点抑制剂治疗的耳毒性。

Ototoxicity in Immune Checkpoint Inhibitors Therapy.

机构信息

Regional Specialist Hospital Wroclaw, Research & Development Centre, Wroclaw, Poland, Faculty of Medicine Wroclaw University of Science and Technology, Wroclaw, Poland.

Regional Specialist Hospital Wroclaw, Research & Development Centre, Wroclaw, Poland.

出版信息

Otolaryngol Pol. 2024 Jun 30;78(3):1-5.

DOI:
Abstract

<b><br>Introduction:</b> Immune checkpoint inhibitors (ICIs) and T-cell therapies are a modern, well-established cancer treatment. The priority of oncological treatment is to cure cancer. However, treatment-related toxicities, i.e. immune-related adverse events (irAEs), continue to emerge and are not that well understood yet. ICIs can cause profound, multiple, and diverse irAEs - the sequelae of unknown mechanisms. One of the organs susceptible to collateral damage is the hearing organ. Complications related to hearing, tinnitus, and balance disorders are extremely burdensome and significantly impair many aspects of the quality of life of patients and survivors.</br> <b><br>Aim:</b> The aim of the work is to review the literature in the area of ototoxicity of ICIs.</br> <b><br>Materials and method:</b> A systematic search of the Web of Science, PubMed, and Embase databases for studies published until 1 March 2022 was conducted.</br> <b><br>Results:</b> Reported clinical symptoms ranged from sudden bilateral hearing loss and imbalance to mild hearing loss or tinnitus with preserved hearing. It was found that the median time from ICI initiation to hearing loss development was 3 months. The hearing impairment was secondary to bilateral sensorineural hearing loss in the majority of patients (>60%), and at least one other irAE accompanied the hearing loss in 2/3 of patients. Hearing loss significantly improved in 45.7% of the patients.</br> <b><br>Conclusions:</b> The majority of cases of ICI-related hearing loss presented in the literature were reversible. Therefore, it is important to develop and implement routine therapeutic algorithms. Further research is needed to define the true prevalence of ICI-related hearing loss, optimal diagnostics, and management.</br&gt.

摘要

<b><br>引言:</b>免疫检查点抑制剂(ICIs)和 T 细胞疗法是一种现代的、成熟的癌症治疗方法。肿瘤治疗的首要任务是治愈癌症。然而,治疗相关的毒性,即免疫相关的不良反应(irAEs),仍在不断出现,且尚未被充分了解。ICI 可引起深刻、多样和不同的 irAEs——其机制未知。易受牵连的器官之一是听觉器官。与听力、耳鸣和平衡障碍相关的并发症极其沉重,严重损害了患者和幸存者生活质量的许多方面。</br> <b><br>目的:</b>本工作的目的是综述 ICI 致聋的文献。</br> <b><br>材料与方法:</b>对截至 2022 年 3 月 1 日在 Web of Science、PubMed 和 Embase 数据库中发表的研究进行了系统检索。</br> <b><br>结果:</b>报道的临床症状范围从双侧突发性听力损失和失衡到轻度听力损失或耳鸣伴听力保留。发现从 ICI 开始到听力损失发展的中位时间为 3 个月。大多数患者(>60%)的听力损害继发于双侧感音神经性听力损失,至少有 2/3 的患者的听力损失伴有另一种 irAE。45.7%的患者听力明显改善。</br> <b><br>结论:</b>文献中报道的大多数 ICI 相关听力损失病例是可逆的。因此,制定和实施常规治疗方案非常重要。需要进一步研究以确定 ICI 相关听力损失的真实患病率、最佳诊断和管理方法。</br&gt。

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