免疫检查点抑制剂在怀孕期间的暴露:系统性审查
Casey L Keller1, Kristina C Hermanson1, Ryan M Schuller1
1Department of Pharmacy, Texas Health Harris Methodist Hospital Fort Worth, Fort Worth, Texas, USA.
Pharmacotherapy
|February 9, 2026
概括
这次审查发现,怀孕期间的免疫检查点抑制剂 (ICI) 可能比以前认为的具有较低的胎儿风险. 临床医生应该在怀孕期间讨论ICI使用的个性化风险-益处.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 孕产妇和胎儿医学 孕产妇和胎儿医学
背景情况:
- 免疫检查点抑制剂 (ICI) 越来越多地用于癌症治疗.
- 关于怀孕期间ICI的数据是有限的.
- 了解怀孕期间ICI的安全性对于临床决策至关重要.
研究的目的:
- 系统地审查和评估免疫检查点抑制剂 (ICI) 暴露在患有癌症的孕妇中的风险-益处概况.
- 综合有关母亲ICI治疗后胎儿结果的现有数据.
主要方法:
- 在PubMed,Scopus,Web of Science和Embase (2011-2025) 的系统文献搜索.
- 包括病例报告和回顾性研究,详细介绍ICI在癌症和胎儿后果的孕妇中的使用.
- 使用Joanna Briggs研究所批判性评估工具进行质量评估.
主要成果:
- 包括20个案例报告和3个回顾性研究.
- 在23%的病例报告中报告了胎儿并发症;在11.5%的病例中报告了与免疫相关的不良事件.
- 在54%的病例报告和20.9%-25.5%的观察性研究中观察到早产;在2.2%-15.3%的观察性研究中观察到胎儿死亡率.
结论:
- 由于怀孕期间使用ICI,胎儿并发症的风险可能低于此前估计的.
- 个性化,多学科的风险-益处讨论对于管理ICI在孕妇患者的使用至关重要.
- 需要进一步的研究,以充分阐明子宫内ICI暴露的长期影响.
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