免疫检查点抑制剂和肝脏:平衡治疗益处和不良事件
Eleonora De Martin1,2, Claudia A M Fulgenzi3, Ciro Celsa3,4
1Centre Hepatobiliaire, Paul Brousse Hospital, Villejuif, France eleonora.demartin@aphp.fr.
Gut
|December 10, 2024
概括
免疫检查点抑制剂 (ICI) 改善癌症存活率,但可能导致肝损伤. 本综述详细介绍了ICI疗效,肝毒性机制以及肝癌和非肝癌的治疗策略.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 肝病学 肝病学是一种肝病学.
背景情况:
- 免疫检查点抑制剂 (ICI) 已经彻底改变了癌症治疗,包括肝细胞癌 (HCC) 和胆道癌.
- 肝脏炎症和功能障碍在肝癌患者中很常见,使ICI治疗复杂化,并增加肝毒性风险.
- 由ICI引起的肝损伤 (ICILI) 是一个重大问题,即使在治疗肝外恶性瘤的患者中也是如此.
研究的目的:
- 审查ICI在肝脏瘤中的疗效和毒性机制.
- 为了探索ICI诱导的肝损伤在肝脏和肝外恶性瘤.
- 为了比较慢性肝病和无慢性肝病患者的ICILI的管理策略和结果.
主要方法:
- 关于ICI治疗肝脏恶性瘤和肝脏毒性的最新进展的文献综述.
- 对ICILI的特点,管理和结果进行比较分析.
- 讨论反应和毒性的预测因素.
主要成果:
- ICI提供生存益处,但携带肝毒性和肝脏不补偿的风险.
- ICILI的呈现和严重程度差异很大,需要准确的诊断和管理.
- 了解慢性肝病与健康肝脏之间的ICILI对于患者的治疗结果至关重要.
结论:
- 为了平衡ICI的益处与肝毒性风险,需要验证的响应预测器.
- 对于肝脏瘤患者和肝外恶性瘤患者来说,有效的ICILI管理是必不可少的.
- 未来的研究应该专注于预测和减轻ICI相关的肝损伤.
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