免疫检查点抑制剂相关不良反应的危险因素与预测因素

Risk factors and predictors of immune-related adverse events induced by immune checkpoint inhibitors

免疫检查点抑制剂普遍应用于临床并取得了较好的疗效,但免疫相关不良反应(irAE)通常不可预测且可能导致严重临床后果。目前irAE的危险因素包括性别、体质量指数、肿瘤类别、药物类型、既往的自身免疫性疾病以及肿瘤突变负荷等,预测因素主要有免疫细胞、细胞因子与趋化因子、自身抗体、基因组以及肠道菌群等。进一步对irAE发生的机制、危险因素、预测因素进行研究,可为临床预测与管理irAE提供指导性建议。

Immune checkpoint inhibitors are commonly used in clinical practice and have achieved good efficacy,but immune-related adverse events(irAEs)are often unpredictable and may lead to serious clinical consequences.Risk factors for irAEs include gender,body mass index,tumor class,drug type,preexisting autoimmune disease,and tumor mutational burden;predictors are mainly immune cells,cytokines and chemokines,autoantibodies,genome,and gut microbes.By further investigating the mechanisms,risk factors and predictors for the occurrence of irAEs,guidance for the clinical prediction and management of irAEs is supposed to be provided.