免疫检查点抑制剂治疗黑色素瘤相关不良反应及其管理策略  

Immune-related adverse events and management strategies of immune checkpoint inhibitor in the treatment of melanoma

作　　者：杨玥 斯璐[1] 郭军[1] YANG Yue;SI Lu;GUO Jun(Key Laboratory of Carcinogenesis and Translational Research,Department of Melanoma and Sarcoma Oncology,Cancer Hospital&Institute Peking University,Beijing 100142,China)

机构地区：[1]北京大学临床肿瘤学院,北京肿瘤医院暨北京市肿瘤研究所黑色素瘤与肉瘤内科暨恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142

出　　处：《中国肿瘤生物治疗杂志》2022年第11期971-977,共7页Chinese Journal of Cancer Biotherapy

基　　金：国家自然科学基金(No.81972562,No.81972566)。

摘　　要：近年来,免疫检查点抑制剂(ICI)在黑色素瘤治疗中取得了显著的成效,但是T细胞功能的活化也引起了一系列免疫相关不良反应(irAE)。不同于传统化疗的不良反应,irAE有着独特的临床表现和处理要求。虽然irAE的发生和管理逐渐得到临床医生的重视,但一些常见irAE的发生机制、临床表现、诊断和鉴别及其综合监测管理仍需进一步总结和归纳,以便提高临床医生工作水平和临床试验设计质量。而且不同irAE的发生机制、糖皮质激素的治疗影响、原有自身免疫疾病患者的治疗风险等问题仍存在争议。本文阐述ICI治疗黑色素瘤引起的irAE相关临床表现特点和诊疗管理措施,旨在对irAE管理策略和研究方向提出具有指导意义的意见。In recent years,immune checkpoint inhibitors(ICIs)have made remarkable achievements in the treatment of melanoma.However,the activation of T cells also causes a series of immune-related adverse events(irAEs).Different from traditional chemotherapy,irAEs have a unique manifestation and need unique treatment.Although clinicians gradually attach importance to the incidence and management of irAEs,the mechanism,presentations,diagnosis and monitoring of some irAEs still need to be further summarized to guide clinical practice and clinical trials.However,the mechanism of different irAEs,the influence of steroid therapy,and the risk of patients with autoimmune diseases receiving ICIs are still controversial.This review provided an overview of the presentation,diagnosis,and treatment of irAEs to inspire management strategies and research interests.

关 键 词：黑色素瘤 免疫检查点抑制剂 免疫相关不良反应 糖皮质激素治疗 

分 类 号：R739.5[医药卫生—肿瘤] R730.51[医药卫生—临床医学] R392.1