Jin Di, Wang Yu-Wei, Lin Zhi-Min, Li Chen, Li Ming
Department of Rheumatology, Weifang People's Hospital, Weifang 261000, Shandong Province, China.
Department of Cardiology, Yidu Central Hospital of Weifang, Weifang 261000, Shandong Province, China.
World J Cardiol. 2024 Sep 26;16(9):546-549. doi: 10.4330/wjc.v16.i9.546.
Tumour immunotherapy represented by immune checkpoint inhibitors (ICIs) has greatly improved the overall prognosis of patients with malignant tumours, and is regarded as an important breakthrough in the field of medicine in recent years. ICIs have gradually become the core of tumour therapy and are increasingly used in the clinic. In order to achieve early clinical prediction and management of immune-related adverse events (irAEs), it is still necessary to perform further research on the mechanisms, risk factors, and predictors of irAE occurrence in the future. Zhou describe the consultation of a patient with advanced gastric cancer combined with chronic plaque psoriasis. This case provides an important reference for the use of programmed cell death protein-1 (PD-1) inhibitors in patients of tumours combined with chronic plaque psoriasis. This case also highlights that screening of high-risk groups for irAEs is critical before applying PD-1 inhibitors to patients with chronic psoriasis combined with tumours. PD-1 inhibitors are new and potent antineoplastic agents that can cause serious immune-related adverse events such as toxic epidermal necrolysis release and psoriasis. Glucocorticosteroids are the first-line agents for irAEs. The incidence of rheumatic irAEs may be higher in reality, which will inevitably become a new challenge for rheumatologists and dermatologists.
以免疫检查点抑制剂（ICI）为代表的肿瘤免疫疗法极大地改善了恶性肿瘤患者的总体预后，被视为近年来医学领域的一项重要突破。ICI已逐渐成为肿瘤治疗的核心，并在临床上得到越来越广泛的应用。为了实现对免疫相关不良事件（irAE）的早期临床预测和管理，未来仍有必要对irAE发生的机制、危险因素和预测指标进行进一步研究。周等人描述了一名晚期胃癌合并慢性斑块状银屑病患者的会诊情况。该病例为肿瘤合并慢性斑块状银屑病患者使用程序性细胞死亡蛋白-1（PD-1）抑制剂提供了重要参考。该病例还强调，在对慢性银屑病合并肿瘤患者应用PD-1抑制剂之前，筛查irAE的高危人群至关重要。PD-1抑制剂是新型强效抗肿瘤药物，可引发严重的免疫相关不良事件，如中毒性表皮坏死松解症和银屑病。糖皮质激素是治疗irAE的一线药物。风湿性irAE的实际发病率可能更高，这将不可避免地成为风湿病学家和皮肤科医生面临的新挑战。
