免疫检查点抑制剂治疗恶性肿瘤诱导甲状腺疾病

A. Glibka, N. Mazurina, K. A. Sarantseva, G. Kharkevich, K. Laktionov, E. Troshina, G. A. Mel`nichenko
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引用次数: 0

摘要

近年来,免疫检查点抑制剂(immune checkpoint inhibitors, ICPI)被广泛应用于多种恶性肿瘤的治疗。在俄罗斯联邦,几种icpi已被批准并积极使用,即抗ctla -4单克隆抗体(ipilimumab),抗pd -1单克隆抗体(nivolumab, pembrolizumab, prolgolimab)和抗pd - l1单克隆抗体(atezolizumab, durvalumab)。icpi可引起各种内分泌免疫介导的不良事件,最常见的是甲状腺功能障碍和垂体炎,这在很大程度上与这些药物的某一亚群的抗肿瘤治疗有关。内分泌免疫介导的不良事件的预测因素尚不清楚,其最佳预防、预测和治疗尚未确定。这篇综述包含了关于甲状腺免疫介导不良事件的机制、生物标志物、特异性特征的文献积累信息,并描述了这些甲状腺疾病的治疗原则。这些信息对肿瘤学家、内分泌学家、内科医生、家庭医生以及其他医学专业都很有用。
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Thyroid disorders induced by immune checkpoint inhibitors therapy of malignant tumors
In the recent years, immune checkpoint inhibitors (ICPI) have been widely used for treatment of many malignant neoplasms. In the Russian Federation, several ICPIs have been approved and actively used, namely anti-CTLA-4 monoclonal antibody (ipilimumab), anti-PD-1 monoclonal antibodies (nivolumab, pembrolizumab, prolgolimab), and anti-PD-L1 monoclonal antibodies (atezolizumab, durvalumab). ICPIs may cause various endocrine immune-mediated adverse events, most commonly thyroid dysfunction and hypophysitis, which are at large associated with anti-tumor therapy with a certain subgroup of these agents. Predictors of endocrine immune-mediated adverse events remain unclear, and their optimal prevention, prediction and treatment have not been yet defined. The review contains the information accumulated in the literature on the mechanisms, biomarkers, specific characteristics of thyroid immune-mediated adverse events and describes the principles of treatment for these thyroid disorders. This information would be useful for practicing oncologists, endocrinologists, internists, family physicians, as well as for any other medical specialties.
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