免疫疗法与化疗组合的毒性跨瘤指示:当前知识和实际建议
Layal Rached1, Ariane Laparra2, Madona Sakkal1
1Gustave Roussy, Department of Therapeutic Innovations and Early Trials, 94805 Villejuif, France.
Cancer treatment reviews
|May 10, 2024
概括
将化疗与免疫检查点抑制剂 (ICI) 结合起来,可以改善癌症存活率,但会增加不良事件. 本综述详细介绍了常见的毒性,并为医疗保健专业人员提供了管理建议.
科学领域:
- 在瘤学瘤学.
- 免疫治疗是一种免疫疗法.
- 临床试验 临床试验
背景情况:
- 化学疗法与免疫检查点抑制剂 (ICI) 结合是一种标准的癌症治疗方法,改善了生存结果.
- 组合疗法具有独特的毒性概况,将细胞毒性影响与免疫相关不良事件 (irAEs) 区分开来.
- 对于临床医生来说,管理这些具有相似表现的独特毒性对临床医生构成挑战.
研究的目的:
- 审查与化疗和ICI组合相关的常见毒性.
- 总结随机临床试验的发现,导致FDA批准这些组合.
- 为在接受组合治疗的患者中管理irAEs提供实际建议.
主要方法:
- 对化疗加ICI组合的随机临床试验的系统审查.
- 对各种瘤指标报告的不良事件的分析.
- 与有经验的器官专家进行咨询. 在irAE管理中.
主要成果:
- 与单独的化疗相比,组合疗法显示所有级别的不良事件 (RR 1.11) 和严重不良事件 (级别≥3) (RR 1.16) 的发生率增加.
- 常见的严重不良反应包括高度腹,呼吸不全,疲劳,皮疹和肝酶升高.
- 在组合治疗中没有观察到与治疗相关的死亡率过多.
结论:
- 化疗加上ICI组合疗法提供了生存益处,但需要对增加的毒性进行仔细监测.
- 了解和管理irAEs对于优化患者护理至关重要.
- 建议提供实用指南,以帮助医生管理这些组合治疗的患者.
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