与免疫检查点抑制剂有关的神经学不良事件:实用性审查
François Zammit1, Emmanuel Seront1
1Institut Roi Albert II, Department of Medical Oncology, Cliniques Universitaires Saint Luc, Avenue Hippocrate 10, 1200 Brussels, Belgium.
Pharmaceuticals (Basel, Switzerland)
|April 27, 2024
概括
免疫检查点抑制剂 (ICI) 可以导致严重的神经系统免疫相关不良事件 (n-irAEs). 早期识别和管理对于患者的结果至关重要,涉及多学科护理和严重程度分级.
科学领域:
- 在瘤学瘤学.
- 神经学 神经学
- 免疫学 免疫学 免疫学
背景情况:
- 免疫检查点抑制剂 (ICI) 越来越多地用于癌症治疗.
- 神经免疫相关的不良事件 (n-irAEs) 是ICI治疗的罕见但严重的并发症.
- n-irAEs可能导致严重的残疾或死亡.
研究的目的:
- 提供对n-irAE的全面概述.
- 专注于对n-irAE的认可和管理.
- 讨论n-irAE的关键特征,差异诊断和治疗策略.
主要方法:
- 关于n-irAEs的现有文献的叙述性审查.
- 专注于临床表现,诊断考虑和治疗方法.
- 包括影响外周和中枢神经系统的n-irAEs.
主要成果:
- n-irAEs包括肌炎,肌病,神经病变,脑炎,脑膜炎和脱髓性疾病.
- 关键特征包括ICI后的早期发病,与非神经学性irrAEs的关联,瘤反应,以及ICI停药/免疫抑制的改善.
- 不同诊断和排除其他病因是至关重要的.
结论:
- 多学科的方法对于诊断和管理n-irAEs至关重要.
- 严重程度分级是指导治疗决策的关键.
- 讨论了ICI重新挑战和管理先前存在的自身免疫/副发性综合征的患者的考虑.
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