免疫检查点抑制剂相关多器官不良反应研究进展

doi:10.3760/cma.j.cn371439-20240515-00085

摘要/Abstract

摘要：

免疫检查点抑制剂（ICI）是一把疗效与不良反应并存的“双刃剑”，为肿瘤患者带来临床获益的同时，免疫相关不良反应（irAE）不容忽视。尤其是ICI导致的多器官不良反应（MO-irAE），临床表现尤为复杂，危重患者占比较高，临床认识和重视不足，管理相对困难，可能危及患者生命。合理应用激素等免疫调节剂、积极对症支持治疗、开展严密监测和长期随访是控制MO-irAE的关键措施。患者的临床特征、外周血指标及遗传易感性等因素在一定程度上能预测MO-irAE的发生发展。全面把握MO-irAE的临床表现、干预措施及转归预后等情况，深入了解其潜在的分子机制和预测因子，有助于有效控制MO-irAE，提高患者临床获益。

关键词: 肿瘤, 免疫检查点抑制剂, 不良反应, 免疫相关多器官不良反应

Abstract:

Tumor immune checkpoint inhibitors （ICIs） present a dual nature，offering therapeutic benefits alongside possible toxic side effects. Despite their significant clinical advantages，immune-related adverse events （irAEs） are major concern. In particular，the multi-organ irAEs （MO-irAEs） caused by ICIs present complex clinical manifestations，affecting a high proportion of critically ill patients. There is a lack of clinical awareness and attention towards these adverse events，making management relatively difficult，thus potentially threatening the life of patients. Reasonable application of hormones and immune modulators，along with symptomatic and supportive treatment，as well as careful monitoring and long-term follow-up are crucial measures to control MO-irAEs. Clinical characteristics，peripheral blood indicators，and genetic predisposition can serve as predictive markers for MO-irAEs occurrence and progression to some extent. A comprehensive understanding of clinical features，intervention measures，prognosis，potential molecular mechanisms and predictive factors of MO-irAEs can help to effectively control MO-irAEs，ultimately improving patient outcomes.

Key words: Neoplasms, Immune checkpoint inhibitors, Adverse events, Multi-organ irAEs

王秋实, 徐瑞涛, 李松, 褚佳慧, 刘联. 免疫检查点抑制剂相关多器官不良反应研究进展[J]. 国际肿瘤学杂志, 2024, 51(8): 510-514.

Wang Qiushi, Xu Ruitao, Li Song, Chu Jiahui, Liu Lian. Research progress of immune checkpoint inhibitor-related multi-organ adverse events[J]. Journal of International Oncology, 2024, 51(8): 510-514.

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