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帕博利珠单抗相关性自身免疫性糖尿病:继续前进,不断学习。

Pembrolizumab autoimmune related diabetes: Moving forward, keep learning.

作者信息

Garcia Jose Angel, Alcaraz Diego, Holgado Esther, Couñago Felipe

机构信息

Department of Medical Oncology, GenesisCare Spain-San Francisco de Asis University Hospital, Madrid 28002, Spain.

Department of Chief of Medical Oncology, GenesisCare Spain-San Francisco de Asis University Hospital, Madrid 28002, Spain.

出版信息

World J Clin Oncol. 2024 May 24;15(5):576-579. doi: 10.5306/wjco.v15.i5.576.

Abstract

Immune checkpoint inhibitors (and more specifically programmed cell death 1/programmed cell death ligand 1 inhibitors as Pembrolizumab) initiated a revolution in the field of melanoma and have now expanded to several tumor subtypes and in increasingly broader clinical contexts, including the adjuvant and neoadjuvant setting, with potentially curable patients and prolonged survival. The side effects related to these drugs include a wide spectrum of manifestations, with endocrinological adverse events being some of the most frequent. Pembrolizumab-induced type 1 diabetes mellitus is an infrequent but potentially serious and not clearly reversible side effect that possesses characteristic clinical features and has high morbidity and mortality, with a chronic impact on quality of life. The etiopathogenesis of this phenomenom needs to be further investigated and a collaborative effort through the involvement of oncologists and other medical specialists is necessary for the correct identification and management of patients at risk.

摘要

免疫检查点抑制剂(更具体地说是程序性细胞死亡蛋白1/程序性细胞死亡配体1抑制剂,如帕博利珠单抗)引发了黑色素瘤领域的一场革命,如今已扩展到多种肿瘤亚型,并应用于越来越广泛的临床环境,包括辅助和新辅助治疗环境,有望治愈患者并延长生存期。这些药物相关的副作用包括广泛的表现,内分泌不良事件是最常见的一些。帕博利珠单抗诱导的1型糖尿病是一种罕见但可能严重且不太明显可逆的副作用,具有特征性临床特征,发病率和死亡率高,对生活质量有长期影响。这种现象的发病机制需要进一步研究,肿瘤学家和其他医学专家共同努力对于正确识别和管理有风险的患者是必要的。

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本文引用的文献

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Endocrine toxicities of immune checkpoint inhibitors.免疫检查点抑制剂的内分泌毒性。
Nat Rev Endocrinol. 2021 Jul;17(7):389-399. doi: 10.1038/s41574-021-00484-3. Epub 2021 Apr 19.
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New insight in endocrine-related adverse events associated to immune checkpoint blockade.免疫检查点阻断相关内分泌不良事件的新认识。
Best Pract Res Clin Endocrinol Metab. 2020 Jan;34(1):101370. doi: 10.1016/j.beem.2019.101370. Epub 2019 Dec 11.
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