Immune checkpoint inhibitor toxicities: systems-based approaches to improve patient care and research
Immune checkpoint inhibitor toxicities: systems-based approaches to improve patient care and research
复制标题
免疫检查点抑制剂毒性：改善患者护理和研究的系统方法
DOI：
10.1016/s1470-2045(20)30107-8
复制
发表时间：
2020-08-01
期刊：
影响因子：
51.1
通讯作者：
Moslehi, Javid J.
中科院分区：
文献类型：
--
作者：
Johnson, Douglas B.;Reynolds, Kerry L.;Moslehi, Javid J.
免疫检查点抑制剂（ICIs）现已被批准用于多种不同的癌症类型和联合治疗方案。 ICI 毒性可能会急性发生、影响任何器官系统并产生许多不同的临床综合征，有效识别和治疗已成为 ICI 管理的基本目标。因此，在整个医疗保健系统中开发针对 ICI 毒性的强大诊断和管理方法是一项紧迫且未得到满足的临床需求。在本个人观点中，我们描述了高质量护理的障碍，这些障碍限制了对接受 ICI 治疗的癌症患者进行最有效的管理。我们审查了旨在提高患者和医生意识的教育举措，考虑到患者经常经历的广泛的 ICI 毒性，这是必要的，并评估各种基于系统的方法，以最大限度地提高适当管理的机会。此外，我们描述了扩大循证方法和这些新事件的病理学的研究渠道。随着这些药物在癌症治疗中的激增，开发有效、系统的方法来识别和治疗 ICI 毒性将变得越来越重要。
Immune checkpoint inhibitors (ICIs) have now been approved in numerous and diverse cancer types and combination regimens. Effective recognition and treatment of ICI toxicities, which might occur acutely, affect any organ system, and produce many distinct clinical syndromes, have emerged as essential goals of ICI management. Thus, developing robust diagnostic and management approaches for ICI toxicity across the health-care system is an urgent and unmet clinical need. In this Personal View, we describe barriers to high-quality care that have constrained the most effective management of patients with cancer receiving ICI treatment. We review education initiatives to enhance patient and physician awareness, which is necessary given the broad spectrum of ICI toxicities often experienced by patients, and assess various systems-based approaches that maximise the chances of appropriate management. In addition, we describe research pipelines that broaden evidence-based approaches and the pathobiology of these novel events. Developing effective, systematic approaches for the recognition and treatment of ICI toxicities will continue to grow in importance as these agents proliferate in cancer care.