糖皮质激素对免疫检查点抑制剂疗效影响的研究进展

Progress of Steroids Effect on Efficacy of Immune Checkpoint Inhibitors

免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)包括程序性死亡受体-1/配体-1单抗和细胞毒性T淋巴细胞相关抗原-4单抗等,因其良好的抗肿瘤活性,目前已被批准用于多种晚期恶性肿瘤的治疗。对于接受ICIs治疗的患者,由于肿瘤的部分并发症、免疫治疗相关不良反应以及免疫联合化疗前预处理等,通常会在ICIs治疗过程中使用糖皮质激素进行干预及处理。但超生理剂量的糖皮质激素会对机体产生一定的免疫抑制作用,甚至可能影响ICIs的疗效。因而临床上对于ICIs治疗患者激素的使用存在一定争论。本文就糖皮质激素对ICIs疗效影响的研究进展进行综述。

Immune checkpoint inhibitors(ICIs),including programmed death receptor-1(PD-1)/ligand(PD-L1)and cytotoxic T-lymphocyte-associated antigen-4(CTLA-4) monoclonal antibody,have been approved for the treatment of multiple advanced malignant tumors,on account of its ideal antitumor activity.For patients receiving ICIs treatment,glucocorticoid intervention and treatment are often applied because of some complications associated with tumor,immunotherapyrelated adverse reactions,and pretreatment before immunotherapy combined with chemotherapy.However,excessive physiological dose of glucocorticoid has a certain immunosuppressive effect,which may even affect the curative efficacy of ICIs.Thus,there are controversies about the use of steroids in patients receiving ICIs treatment.In this article,we reviewed the progress of steroids effect on the efficacy of ICIs.