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在患有与免疫检查点抑制剂相关的内分泌病症的人群中,管理,生物标志物和预后

Shintaro Iwama¹, Tomoko Kobayashi², Hiroshi Arima³

¹Department of Endocrinology and Diabetes, Nagoya University Hospital, Nagoya, Japan. iwama.shintaro.m1@f.mail.nagoya-u.ac.jp.

Nature reviews. Endocrinology

|January 8, 2025

概括

用免疫检查点抑制剂进行的癌症免疫治疗可以导致内分泌免疫相关不良事件 (irAEs). 使用生物标志物识别患有垂体和甲状腺irrAEs风险的患者,可能会改善癌症治疗结果.

科学领域:

内分泌学在内分泌学.
在瘤学瘤学.
免疫学免疫学免疫学

背景情况:

免疫检查点抑制剂 (ICI) 正在彻底改变癌症治疗,但可以引发与免疫相关的不良事件 (irAEs).
内分泌IRAE,特别是影响垂体和甲状腺,是常见的,如果管理不当,可能是严重的,甚至危及生命.
相反,通过激素替代治疗及时管理内分泌IRAE,可以改善癌症的预后.

研究的目的:

审查与ICI相关的内分泌IRAE的临床特征和管理.
突出生物标志物的潜力,预测内分泌IRAE的发展.
根据当前的研究和指导方针提供概述.

主要方法:

对内分泌IRAEs的临床特征和管理策略的文献综述.
分析最近的研究成果和学术协会的指导方针.
专注于垂体,甲状腺,上腺和糖尿病相关的IRAE.

主要成果:

脑下垂体和甲状腺的IRAE是最常见的,其次是上腺功能不充分,1型糖尿病和甲状腺功能低下.
下垂体irAEs和1型糖尿病都会分别带来上腺危机和糖尿病酸性脂肪酸症的风险.
反垂体和甲状腺自身抗体显示出作为预测性生物标志物对irAEs的承诺.

结论:

内分泌IRAE在ICI治疗中是一个重大问题,需要谨慎监测和管理.
通过生物标志物早期识别有风险的患者对于主动干预至关重要.
适当的激素替代疗法用于内分泌irAEs可以与有利的瘤结果相关.

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