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免疫检查点抑制剂诱发的消化性溃疡经糖皮质激素成功治疗:三例报告及文献综述

Peptic ulcer induced by immune checkpoint inhibitors successfully treated with glucocorticoids: A report of three cases and a literature review.

作者信息

Wang Qingzhe, Yu Min, Zhang Shuang

机构信息

Department of Targeting Therapy and Immunology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.

Division of Thoracic Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.

出版信息

Exp Ther Med. 2024 Aug 28;28(5):410. doi: 10.3892/etm.2024.12699. eCollection 2024 Nov.

Abstract

In recent decades, immune checkpoint inhibitors (ICIs) have emerged as safer and less disruptive alternatives to conventional chemotherapy and radiotherapy for certain patients with tumours. ICIs serve a synergistic role alongside conventional therapies by manipulating the immune system to recognise and target tumour cells. However, excessive activation of the immune system can lead to immune-related adverse events including pneumonia, myocarditis and colitis, which pose serious and even fatal risks. In the present case series, three patients with a thoracic tumour with an ICI-induced peptic ulcer triggered by programmed cell death protein 1 antibodies (diagnosed by gastrointestinal endoscopy) are presented. These cases were successfully treated with corticosteroids. The diagnostic and treatment processes undertaken for these patients underscore the requirement to comprehensively understand the mechanism of ICI-induced peptic ulcer. Moreover, the relevant literature was also reviewed in the present study.

摘要

近几十年来,免疫检查点抑制剂(ICIs)已成为某些肿瘤患者更安全、干扰性更小的传统化疗和放疗替代方案。ICIs通过操纵免疫系统来识别和靶向肿瘤细胞,与传统疗法发挥协同作用。然而,免疫系统的过度激活会导致免疫相关不良事件,包括肺炎、心肌炎和结肠炎,这些会带来严重甚至致命的风险。在本病例系列中,介绍了3例因程序性细胞死亡蛋白1抗体引发ICI诱导的消化性溃疡的胸段肿瘤患者(通过胃肠内镜检查确诊)。这些病例通过皮质类固醇成功治愈。对这些患者进行的诊断和治疗过程强调了全面了解ICI诱导消化性溃疡机制的必要性。此外,本研究还对相关文献进行了综述。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/efe8/11384188/094fc424bec0/etm-28-05-12699-g00.jpg

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