免疫检查点抑制剂主要内分泌不良反应急症处理中国专家共识

重庆医科大学学报2023年第48卷第1期(Joumal of Chongging Medical University2023.Vol.48Nb.1)一1专家共识D01:10.134065.cmki.cyxh.002758免疫检查点抑制剂主要内分泌不良反应急症处理中国专家共识中国抗癌协会肿瘤内分泌专业委员会，重庆市生物医药技术学会肿瘤内分泌专业委员会，重庆市中西医结合学会肿瘤内分沁专业委员会摘要免疫检查点抑制剂mmune checkpoint inhibitors,lC巧s)是新兴的抗肿瘤药物，内分泌不良反应是其较为常见的药物不良反应，主要累及多个内分泌腺如甲状腺、垂体、肾上腺和胰腺等，导致内分泌功能紊乱。其急症如不能在早期得到正确的鉴别和防治，可能会危及生命。国内外虽已推出相关指南供识多部，但国内尚无针对ICPs导致内分泌不良反应急症的诊治流程和共识。为规范和提高相关科室临床诊治水平，本共识回顾分析了多项国内外专家共识和临床研究，综合肿瘤学、内分泌学和护理学专家意见后制订本共识。佚键词悗疫检查点抑制剂：内分泌不良反应：急症中图分类号R588.6仪献标志码A收稿日期2020-02-25Chinese expert consensus on immune checkpoint inhibitors inducedemergency management of endocrine adverse reactionsOnco-endocrinology Committee of Chinese Anti-Cancer Association,Onco-endocrinology Committee of Chongqing A ssociation of Biomedical Technology,Onco-endocrinology Committee of Chongqing Association of Integraive MedicineAbstract Immune checkpoint inhibitors (CPis)are emerging anti-tumor drugs,with endocrine adverse reactions as its most commonadverse drug reactions,and mainly involves multiple endocrine glands,such as glands of thyroid,pituitary,adrenal and pancreas,leading to endocrine dysfunction.If its emergencies can not be correctly identified and prevented in the early stage,it may be life-threatening.Although a number of relevant guidelines/consensuses have been published at home and abroad,there is no consensus onthe diagnosis and treatment process of endocrine adverse reactions caused by ICPis in China.In order to standardize and improvethe clinical diagnosis and treatment level of relevant departments,we have reviewed and analyzed a number of domestic and interna-tional expert consensuses and clinical studies,and formulated this consensus based on integration of the opinions of oncology,en-docrinology and nursing experts.Key words immune checkpoint inhibitor;endocrine adverse reaction;emergency强抗肿瘤免疫应答，抑制免疫逃逸，诱导肿瘤细胞死亡，从而1免疫检查点抑制剂导致内分泌不良反应概述达到抗肿瘤的目的。目前ICPs主要包括细胞毒T淋巴细胞相关抗原-4抑制剂(ytotoxic T lymphocyte-associated antigen-免疫检查点抑制剂mmune checkpoint inhibitors,ICPis）4 inhibitor,CTLA-4 inhibitor)、程序性细胞死亡蛋白-1抑制是通过特异性地阻断免疫抑制分子，靶向T细跑调控途径，增剂programmed death-1 inhibitor,PD-1 inhibitor)及其配体通信作者：周琦，Email:i小o9128@163.cm。programmed cell death--ligand 1,PD-LI inhibitor)。免疫治疗基金项目：国家科技部重大专项资助项目觞号：2016YF℃1303702)：可显著改善许多肿瘤的预后-。目前，免疫治疗可以单靶点、重庆市科技局科研机构绩效激励引导专项面上资助项目双靶点或免疫治疗+化疗或放疗，免疫治疗的应用受到极大重偏号：cstc2019jxjl130006):重庆市科枝局与卫健委联合中视，并往前线治疗推移，其治疗效果为晚期和复发性恶性肿医药技术创新与应用发展资助项目觞号：2020ZY013540)。瘤治疗带来获益，也受到免疫相关不良反应mmune-related优先出版：httpa://kns.cnki.ne /kems/keai/50.1046r20210308.1536.02.liml021-0B-10)adverse events,irAEs)的限制，特别是在联合治疗过程中。