PD-1抑制剂临床不良反应监测评价与探讨

Evaluation and discussion on the monitoring of clinical adverse reactions caused by PD-1 inhibitors

目的 :评价PD-1抑制剂临床不良反应监测现状。方法 :通过实时审方系统、电子病例系统筛选出使用PD-1抑制剂的患者,记录患者基本情况和治疗情况。结果 :共82例患者使用PD-1抑制剂,免疫治疗前仅29例患者进行了全部基线水平监测,12例患者末做任何检查。在治疗期间,有66例患者进行了监测,但监测不到位存在缺项,16例患者未做任何不良反应监测。治疗期间出现的毒性反应多数为G1~2级,表现为皮肤毒性、血液毒性、肝肾毒性和内分泌毒性等。结论 :临床使用PD-1抑制剂并未建立起不良反应监测评价体系,存在监测不到位、评价不规范。因此,临床医生和药师应加强对PD-1抑制剂临床不良反应的监测及评价。

Objective:To evaluate the current status of the monitoring of clinical adverse reactions caused by PD-1 inhibitors.Methods:The patients who used PD-1 inhibitors were screened out by the real-time review system and electronic case system and the basic conditions and treatment of these patients were recorded.Results:There were a total of 82 patients in the use of PD-1 inhibitors,only 29 patients underwent full baseline monitoring and 12 patients did not undergo any examination before immunotherapy.During the treatment period,66 patients were monitored,but the monitoring was not in place and there existed deficiencies,and 16 patients were not monitored for any adverse reactions.During the treatment,most of the toxic reactions were G1-2 grade,manifested as skin toxicity,blood toxicity,liver and kidney toxicity and endocrine toxicity.Conclusion:The clinical use of PD-1 inhibitors has not yet established an adverse reaction monitoring and evaluation system,and therefore,clinicians and pharmacists should strengthen the monitoring and evaluation of clinical adverse reactions caused by PD-1 inhibitors.