PD-1/PD-L1阻断剂免疫治疗不良反应及其处理原则  

Optimal management of immune-related adverse events associated with PD-1/PD-L1 inhibitors immunotherapy

作　　者：黄乐富[1] 邸岩[1] 徐小寒[1] 孙元元[1] 王苗苗[1] 贺子轩[1] 景句 周心娜[1] 王小利[1] 任军[1] 

机构地区：[1]首都医科大学附属北京世纪坛医院肿瘤内科肿瘤治疗性疫苗北京市重点实验室,北京100038

出　　处：《中国药物应用与监测》2017年第3期177-182,共6页Chinese Journal of Drug Application and Monitoring

基　　金：北京市医院管理局临床技术创新项目扬帆计划项目资助(XMLX201413)

摘　　要：免疫治疗成为继手术、放疗、化疗后又一种重要的抗肿瘤手段。其中抗程序细胞死亡蛋白1(programmed death-1,PD-1)及配体(PD-1 ligand,PD-L1)免疫检查点阻断剂,在肿瘤治疗中取得了突破性进展,已被美国食品药品管理局(FDA)批准用于恶性黑色素瘤、转移性鳞状非小细胞肺癌、晚期肾癌、头颈鳞状细胞癌、尿路上皮癌等治疗,但随着PD-1/PD-L1阻断剂在临床上逐步推广,越来越多的免疫相关副反应(immune-related adverse events,ir AEs)引起关注。本文对PD-1/PD-L1阻断剂治疗引起的各器官的免疫相关不良反应以及对应临床处理方法进行综述,有助于临床医护工作者诊断、预防及治疗其相关不良反应。Immunotherapy has become an important anti-tumor means following surgery, radiotherapy and chemotherapy. （PD-1） and PD-1 （PD-L1） immune checkpoint blockers have made a breakthrough, the US Food and Drugs Administration （FDA） has approved the use of nivolumab and pembrolizumab for the treatment of malignant melanoma and nivolumab for squamous non-small cell lung cancer, urothelium carcinoma, etc. However, as PD-1/PD-L1 blockers become more widely used clinically, the inevitable more immune-related adverse events （irAEs） should be addressed. In this paper, immune-related adverse effects of PD-1/PD-L1 blockers in various organs and the corresponding clinical treatment methods are reviewed, which will help clinicians to diagnose, prevent and treat their related adverse reactions.

关 键 词：免疫检查点 PD-1 PD-L1 不良反应 免疫治疗 

分 类 号：R979.1[医药卫生—药品]