Journal of Modern OncologyJournal of Modern OncologyСовременная онкология1815-14341815-1442LLC Obyedinennaya Redaktsiya7793810.26442/18151434.2021.2.200502CLINICAL ONCOLOGYКЛИНИЧЕСКАЯ ОНКОЛОГИЯReview ArticleImmune-mediated adverse events in immune checkpoint inhibitors therapy: literature reviewИммуноопосредованные нежелательные явления при терапии ингибиторами контрольных точек иммунитета: обзор литературыhttps://orcid.org/0000-0002-9558-5579LyadovaMarina A.ЛядоваМарина Александровна
Russian Federation

Cand. Sci. (Med.)

канд. мед. наук, зав. отд-нием химиотерапии

dr.lyadova@gmail.comhttps://orcid.org/0000-0002-7281-35915385-7889LyadovVladimir K.ЛядовВладимир Константинович
Russian Federation

D. Sci. (Med.), Assoc. Prof.

д-р мед. наук, доц., зав. каф. онкологии НГИУВ – филиала ФГБОУ ДПО РМАНПО, доц. каф. онкологии и паллиативной медицины им. акад. А.И. Савицкого ФГБОУ ДПО РМАНПО; зав. отд-нием онкологии №4 ГБУЗ ГКОБ №1

vlyadov@gmail.comCity Clinical Cancer Hospital №1ГБУЗ «Городская клиническая онкологическая больница №1» Департамента здравоохранения г. МосквыRussian Medical Academy of Continuous Professional EducationФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииNovokuznetsk State Institute of Postgraduate Medical Education – branch of the Russian Medical Academy of Continuous Professional EducationНовокузнецкий государственный институт усовершенствования врачей – филиал ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России160820212323193261308202113082021Copyright ©; 2021, Consilium MedicumCopyright ©; 2021, ООО "Консилиум Медикум"2021Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc/4.0https://modernonco.orscience.ru/1815-1434/article/view/77938

Immune-mediated adverse events (imAEs) are complications of therapy with immune checkpoint inhibitors, which arise as a result of autoimmune inflammation. The article summarizes systemic (fatigue, fever), cutaneous (rash, itching), gastrointestinal (diarrhea, colitis, hepatitis, pancreatic dysfunction), endocrinological (hypothyroidism, hypophysitis, adrenal insufficiency, diabetes mellitus), pulmonary (pneumonitis, pleuritis), rheumatological (arthralgia), neurological (headache, sensory and motor disorders), renal (acute interstitial nephritis, lupus-like nephritis, granulomatous nephritis, diffuse interstitial nephritis and minimal change disease), hematological (anemia, cytopenia), cardiovascular (myocarditis) and ocular (conjunctivitis, episcleritis, ceratitis, blepharitis and uveitis) imAE. Pathogenetic mechanisms and treatment approaches (in accordance with toxicity grade and clinical recommendations) are discussed. Early symptom recognition, patient education and timely intervention are crucial for imAE correction.

Иммуноопосредованные нежелательные явления (иоНЯ) – осложнения, возникающие на фоне терапии ингибиторами контрольных точек, в основе развития которых лежит аутоиммунное воспаление. В статье подробно проанализированы системные (слабость, утомляемость, лихорадка), кожные (сыпь, зуд), желудочно-кишечные (диарея, колит, гепатит, нарушения со стороны поджелудочной железы), эндокринологические (гипотиреоз, гипофизит, недостаточность коры надпочечников, сахарный диабет), легочные (пневмонит, плеврит), ревматологические (артралгия), неврологические (головная боль, двигательные и чувствительные нарушения), почечные (острый интерстициальный нефрит, волчаночноподобный нефрит, гранулематозный нефрит, диффузный интерстициальный нефрит или нефропатия с минимальными изменениями), гематологические (анемия, цитопения), кардиоваскулярные (миокардит) иоНЯ, а также иоНЯ со стороны органа зрения (конъюнктивит, эписклерит, кератит, блефарит, увеит). Представлены механизм развития иоНЯ и основные подходы к терапии (в соответствии со степенью токсичности и разработанными клиническими рекомендациями). Раннее распознавание симптомов, обучение пациентов и быстрое вмешательство имеют ключевое значение в коррекции иоНЯ.

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