[免疫检查点抑制剂的内分泌不良反应]
1Mellkasi és Hasüregi Daganatok és Klinikai Farmakológiai Osztály "Kemoterápia B", Országos Onkológiai Intézet, Budapest, Hungary. zsnemethzsuzsanna@gmail.com.
Magyar onkologia
|December 12, 2025
概括
免疫检查点抑制剂 (ICI) 可以在约10%的癌症患者中引起内分泌免疫相关不良事件 (irAEs). 管理侧重于激素替代,因为内分泌损伤往往是永久的,而ICI中止通常是不必要的.
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) 是革命性的癌症治疗方法.
- ICI可以破坏免疫平衡,导致与免疫相关的不良事件 (irAEs).
- 内分泌IRAE影响大约10%的患者,可能会影响多个内分泌腺.
研究的目的:
- 审查与ICI相关的内分泌不良事件.
- 概述这些IRE的症状,诊断方法和管理策略.
主要方法:
- 从ICI治疗中对内分泌IRAE进行文献综述.
- 对临床表现,诊断和治疗结果的分析.
- 为管理内分泌IRE制定指导方针.
主要成果:
- 内分泌irAEs通常影响甲状腺和垂体腺,但也可能涉及上腺,胰腺和副甲状腺.
- 治疗通常需要终身激素替代治疗,与其他IRAE不同.
- 高剂量的皮质类固醇一般不适用,除了特殊情况下,如低血炎或甲状腺毒性危机.
- 由于不可逆转的内分泌损伤,永久性ICI中止往往没有益处.
结论:
- 内分泌IRAE是ICI治疗的一个重要问题,需要专门的管理.
- 早期诊断和适当的激素替代对患者的结果至关重要.
- 对于瘤学家和内分泌学家来说,了解内分泌IRAE的独特管理原则至关重要.
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