免疫检查点抑制剂的内分泌不良事件:全面审查
Remya Rajan1, Devika Nandakumar1
1Department of Endocrinology, Diabetes and Metabolism, Christian Medical College Vellore, Vellore, Tamil Nadu, India.
Indian journal of endocrinology and metabolism
|September 8, 2025
概括
免疫检查点抑制剂 (ICI) 可以导致内分泌疾病,如甲状腺功能障碍和糖尿病. 这些与免疫相关的不良事件的早期识别和管理对于接受ICI治疗的癌症患者至关重要.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 内分泌学 在内分泌学.
背景情况:
- 免疫检查点抑制剂 (ICI) 正通过增强T细胞反应来彻底改变癌症治疗.
- 对ICI的一个重大挑战是免疫相关不良事件 (irAEs) 的发生,特别是内分泌病变.
研究的目的:
- 审查与ICI治疗相关的内分泌疾病的发生率,病理生理学,诊断和管理.
- 为管理这些IRE的瘤学家和内分泌学家提供见解.
主要方法:
- 对ICI相关的内分泌疾病的文献综述.
- 目前对病理生理学,临床表现和管理策略的理解概述.
主要成果:
- 常见的ICI诱导的内分泌异常包括甲状腺功能障碍,缺血症,原发性上腺功能不足 (PAI) 和糖尿病.
- 甲状腺功能障碍往往呈现为双相 (甲状腺毒毒症到甲状腺功能低下症).
- 低血清炎通常导致ACTH缺乏;ICI-糖尿病是由β细胞破坏引起的,通常呈现为DKA;PAI很罕见,但识别至关重要.
结论:
- 内分泌毒性是可以管理的,ICI治疗的好处往往超过了适当的激素替代治疗的风险.
- 早期诊断和管理ICI相关的内分泌病变对于患者的治疗结果至关重要.
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