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Management of Gastrointestinal Toxicity from Immune Checkpoint Inhibitor

机译:免疫检查点抑制剂对胃肠道毒性的管理

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摘要

Immune checkpoint inhibitors have shown anti-tumour activity in cancers such as melanoma, renal cell carcinoma, non-small-cell lung cancer, urothelial carcinoma, colorectal cancer, and Hodgkin's lymphoma. Though immune checkpoint inhibitors have revolutionized the treatment and prognosis of some advanced malignancies, they are also associated with a significant risk of immune-related adverse events. These adverse events can occur in any organ system, but gastrointestinal side effects are among the most commonly reported, with manifestations ranging from mild diarrhoea to severe colitis, sharing some features with inflammatory bowel disease. Anticipating a greater use of these drugs in the future, gastroenterologists should expect to be increasingly faced with gastrointestinal immune-related adverse events. Knowledge of these toxicities, as well as effective management algorithms, is essential to enable early diagnosis and treatment, decreasing morbidity and mortality. We reviewed the currently available literature on gastrointestinal toxicity induced by immune checkpoint inhibitors, namely the clinical features, diagnosis, and management.
机译:免疫检查点抑制剂已在黑色素瘤,肾细胞癌,非小细胞肺癌,尿路上皮癌,结直肠癌和霍奇金淋巴瘤等癌症中显示出抗肿瘤活性。尽管免疫检查点抑制剂已彻底改变了某些晚期恶性肿瘤的治疗和预后,但它们也与免疫相关不良事件的重大风险有关。这些不良事件可以发生在任何器官系统中,但是胃肠道副作用是最常见的报告,其表现范围从轻度腹泻到严重的结肠炎,与炎症性肠病共有一些特征。预计将来会更多地使用这些药物,肠胃科医生应期望越来越多地面临与胃肠道免疫相关的不良事件。了解这些毒性以及有效的管理算法,对于早期诊断和治疗,降低发病率和死亡率至关重要。我们回顾了目前有关免疫检查点抑制剂引起的胃肠道毒性的文献,即临床特征,诊断和治疗。

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