Management of immune checkpoint blockade dysimmune toxicities: a collaborative position paper
Management of immune checkpoint blockade dysimmune toxicities: a collaborative position paper
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DOI：
10.1093/annonc/mdv623
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发表时间：
2016-04-01
影响因子：
50.5
通讯作者：
Marabelle, A.
中科院分区：
文献类型：
--
作者：
Champiat, S.;Lambotte, O.;Marabelle, A.
根据Gustave Roussy免疫治疗的临床实践和免疫相关不良事件管理的经验，以及我们的器官专家网络，我们在此提出一些实用指南，供肿瘤学家帮助接受免疫检查点阻断治疗的患者的临床护理。针对免疫检查点分子CTLA-4和PD-1的单抗最近已获准用于治疗转移性黑色素瘤和晚期/难治性非小细胞肺癌。因此，它们的使用将不再局限于参与临床试验的选定医院。事实上，它们将在世界各地的许多癌症中心常规开出。除了它们的疗效外，这些免疫靶向药物还会产生免疫相关的不良事件(IrAE)。这一新的Dysimmune毒性家族在很大程度上仍不为广大肿瘤学所知。虽然严重的急性脑梗塞仍然很少见(类似于10%的单一治疗病例)，但如果没有预料到和处理得当，它们可能会危及生命。在过去的5年里，古斯塔夫·鲁西在免疫检查点阻断(ICB)抗体的处方和毒性管理方面积累了重要的经验。在Gustave Roussy拥有irAEs专业知识的器官专家网络的合作下，我们在此提出了一些实用的指导原则，供肿瘤学家在ICB免疫疗法下帮助患者的临床护理。
On the basis of Gustave Roussy immunotherapy clinical practice and experience in immune-related adverse events management together with our network of organs' specialists, we propose here some practical guidelines for the oncologist to help in the clinical care of patients under immune checkpoint blockade therapy.Monoclonal antibodies targeted against the immune checkpoint molecules CTLA-4 and PD-1 have recently obtained approval for the treatment of metastatic melanoma and advanced/refractory non small-cell lung cancers. Therefore, their use will not be limited anymore to selected hospitals involved in clinical trials. Indeed, they will be routinely prescribed in many cancer centers across the world. Besides their efficacy profile, these immune targeted agents also generate immune-related adverse events (irAEs). This new family of dysimmune toxicities remains largely unknown to the broad oncology community. Although severe irAEs remain rare (similar to 10% of cases under monotherapy), they can become life-threatening if not anticipated and managed appropriately. Over the last 5 years, Gustave Roussy has accumulated a significant experience in the prescription of immune checkpoint blockade (ICB) antibodies and the management of their toxicities. Together with the collaboration of Gustave Roussy's network of organ specialists with expertise in irAEs, we propose here some practical guidelines for the oncologist to help in the clinical care of patients under ICB immunotherapy.