近几年,美国食品药品管理局(FDA)相继批准了抗细胞毒T淋巴细胞相关抗原4(CTLA-4)和抗程序性死亡受体1(PD-1)两种免疫检测点抑制剂(ICBs)用于黑色素瘤和非小细胞肺癌的治疗.研究发现,ICBs在多种肿瘤亚型的治疗中均有效,包括小细胞肺癌、肾细胞癌、尿道上皮癌、头颈鳞状细胞癌、胃癌、肝细胞癌、卵巢癌、三阴性乳腺癌以及错配修复缺陷型直肠癌等.这些以免疫系统为靶点的药物疗效显著,但同时伴随一定的免疫相关不良事件(irAEs)或者免疫异常毒性的发生,如何管理这些毒副作用尚没有成熟的方法.本综述将对目前国内外关于ICBs免疫异常毒性的管理相关经验进行总结,以期能够给临床医师在肿瘤患者的免疫异常毒性管理工作中提供一些参考.%In recent years, two types of immune checkpoint blockades (ICBs), anti programmed death 1 (PD-1) and anti-cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) antibodies, have been approved by the US food and drug administration (FDA) for treatment of melanoma and non-small cell lung cancer.Studies found that ICBs were effective for most tumors, including small cell lung cancer, renal cell carcinoma, urethral carcinoma, head and neck squamous cell carcinoma, gastric cancer, hepatocellular carcinoma, ovarian cancer, triple-negative breast cancer and mismatch repair-deficient colorectal cancer, etc.These ICBs could effectively target the immune system, but often company with a certain degree of immune adverse events (irAEs) or dysimmune toxicities.How to manage these toxicities and side effects is yet uncertain.In this review, we summarized the international and domestic management experiences of dysimmune toxicities of ICBs, in order to provide references to oncologist during the management of tumor patients.
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