The Current Understanding of the Endocrine Effects From Immune Checkpoint Inhibitors and Recommendations for Management.
The Current Understanding of the Endocrine Effects From Immune Checkpoint Inhibitors and Recommendations for Management.
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DOI：
10.1093/jncics/pky021
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发表时间：
2018-07
影响因子：
4.4
通讯作者：
Investigational Drug Steering Committee (IDSC) Immunotherapy Task Force collaboration
中科院分区：
文献类型：
--
作者：
Girotra M;Hansen A;Farooki A;Byun DJ;Min L;Creelan BC;Callahan MK;Atkins MB;Sharon E;Antonia SJ;West P;Gravell AE;Investigational Drug Steering Committee (IDSC) Immunotherapy Task Force collaboration
过去十年的临床试验已经确定了免疫检查点抑制作为癌症革命性治疗的抗肿瘤作用。即，针对细胞毒性T淋巴细胞抗原4和程序性死亡1或其配体的阻断抗体已达到常规临床用途。免疫系统的操作并非没有副作用，并且观察到通常称为免疫相关不良事件（IRAE）的自身免疫毒性。内分泌IRAE，如垂体炎、甲状腺功能障碍和胰岛素依赖型糖尿病，可表现出使用传统化疗药物所未见的独特特征。在这篇综述中，我们讨论了目前关于这些内分泌疾病的机制及其临床表现的假设。此外，我们还提出了患者管理和未来临床试验的指南和算法，以优化免疫检查点相关内分泌病的检测和治疗。
Clinical trials in the past decade have established the antitumor effects of immune checkpoint inhibition as a revolutionary treatment for cancer. Namely, blocking antibodies to cytotoxic T-lymphocyte antigen 4 and programmed death 1 or its ligand have reached routine clinical use. Manipulation of the immune system is not without side effects, and autoimmune toxicities often known as immune-related adverse events (IRAEs) are observed. Endocrine IRAEs, such as hypophysitis, thyroid dysfunction, and insulin-dependent diabetes mellitus, can present with unique profiles that are not seen with the use of traditional chemotherapeutics. In this Review, we discuss the current hypotheses regarding the mechanism of these endocrinopathies and their clinical presentations. Further, we suggest guidelines and algorithms for patient management and future clinical trials to optimize the detection and treatment of immune checkpoint–related endocrinopathies.