免疫检查点抑制剂治疗的器官特异性不良事件,特别涉及内分泌疾病。

TouchREVIEWS in endocrinology Pub Date : 2021-04-01 Epub Date: 2021-04-28 DOI:10.17925/EE.2021.17.1.21
Annu Susan George, Cornelius J Fernandez, Dilip Eapen, Joseph M Pappachan
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引用次数: 7

摘要

免疫检查点抑制剂是一种有效且有前景的免疫治疗剂,越来越多地用于治疗各种类型的晚期癌症。这组药物的广泛批准同时揭示了免疫相关的不良事件是独特的副作用。内分泌疾病是最常见的免疫相关不良事件之一。这些内分泌疾病的确切致病机制尚不清楚。尽管很少有内分泌疾病是可逆的,只需要控制症状,但大多数是不可逆转的,需要多种长期激素替代疗法。然而,与其他器官特异性免疫相关不良事件相比,内分泌疾病患者可以继续进行免疫检查点治疗,前提是激素替代治疗足够且症状得到控制。尽管出现免疫相关不良事件的患者表现出优异的抗肿瘤活性和总生存率,但由于与免疫相关不良反应相关的高发病率,研究人员正试图将与免疫检查点抑制剂治疗相关的抗肿瘤活动与免疫相关的不良事件脱钩,以保持抗肿瘤活性而没有不良事件。
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Organ-specific Adverse Events of Immune Checkpoint Inhibitor Therapy, with Special Reference to Endocrinopathies.

Immune checkpoint inhibitors are potent and promising immunotherapeutic agents that are increasingly used for the management of various types of advanced cancers. The widespread approval of this group of drugs simultaneously revealed immune-related adverse events as unique side-effects. Endocrinopathies are one of the most common immune-related adverse events. The precise pathogenic mechanisms for these endocrinopathies are still unclear. Though few of the endocrinopathies are reversible, calling for only symptom control, most are irreversible, requiring multiple long-term hormone replacement therapies. However, in contrast to other organ-specific immune-related adverse events, patients with endocrinopathies can continue their immune checkpoint therapy, provided the hormone replacement therapy is adequate and the symptoms are controlled. Though patients who have developed immune-related adverse events demonstrate superior antitumor activity and overall survival, due to the high morbidity associated with the immune-related adverse events, researchers are trying to uncouple the antitumour activity associated with immune checkpoint inhibitor therapy from the immune-related adverse events, to preserve antitumour activity without adverse events.

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