癌症免疫检查点抑制剂的肝胆并发症

Donna Zhuang, David Zhang, Stephen Riordan
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摘要

免疫检查点抑制剂(ICIs)极大地改变了癌症治疗的格局。在过去的十年中,它们在试验中的主要关注点和临床应用都呈指数级增长,在改善各种癌症类型的生存率方面的疗效一再得到证明。这些药物对各器官系统的不良影响在早期阶段的研究中就已被认识到。由于 ICIs 刚上市不久,人们对 ICIs 的短期和长期影响以及在实际环境中的管理越来越感兴趣。与 ICI 相关的肝胆毒性通常很难诊断,也很难与其他导致肝脏生化检查失常的原因区分开来。本综述旨在对 ICIs 的肝胆并发症进行最新、最详细的探讨,包括发病机制以及诊断和管理方法。
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Hepatobiliary complications of immune checkpoint inhibitors in cancer
Immune checkpoint inhibitors (ICIs) have dramatically changed the landscape of cancer therapy. Over the last decade, both their primary focus in trials and clinical application have exponentially risen, with repeated demonstrations of their efficacy in improving survival in various cancer types. The adverse effects of these drugs on various organ systems were recognised in early phase studies. Given their relatively new emergence on the market, there has been increasing interest into short- and long-term effects and management of ICIs in real-world settings. ICI-related hepatobiliary toxicities are often challenging to diagnose and difficult to distinguish from other causes of deranged liver biochemical tests. The aim of this review is to provide an up-to-date and detailed exploration of the hepatobiliary complications of ICIs, including pathogenesis and approaches to diagnosis and management.
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