免疫检查点抑制剂毒性反应影像评估新进展

孙 晨文1, 赵 振华2
1、浙江大学医学院;浙江省绍兴市人民医院放射科
2、浙江省绍兴市人民医院放射科

摘要


肿瘤免疫治疗是当前重要的抗癌药物研究领域。免疫检查点抑制剂(ICI)疗法在晚期和转移性癌症治疗中
已经得到评估和应用,可以显著提升患者的生存率。ICI通过增强细胞免疫,提高宿主的抗肿瘤免疫力,同时也伴随
着免疫相关不良事件(irAEs)的出现。irAEs的早期诊断对于正确和快速地管理患者至关重要,掌握其的影像学表现
是及时排除其他诊断的关键。同时,在影像学新技术领域对irAEs的评估也不断取得新进展。本综述根据受累器官的
不同,对主要irAEs影像学表现和鉴别诊断进行了总结,并对新技术的发展进行展望。

关键词


免疫检查点抑制剂;免疫相关不良事件;ICI;irAEs;免疫治疗

全文:

PDF


参考


[1]MALLIO C A, BERNETTI C, CEA L, et al.Adverse Effects of Immune-Checkpoint Inhibitors: A

Comprehensive Imaging-Oriented Review [J]. Curr Oncol,

2023, 30(5): 4700-23.

[2]MARTINS F, SOFIYA L, SYKIOTIS G P, et

al. Adverse effects of immune-checkpoint inhibitors:

epidemiology, management and surveillance [J]. Nat Rev Clin

Oncol, 2019, 16(9): 563-80.

[3]ABDEL-RAHMAN O, ELHALAWANI H,

FOUAD M. Risk of endocrine complications in cancer

patients treated with immune check point inhibitors: a metaanalysis [J]. Future Oncol, 2016, 12(3): 413-25.

[4]CASTILLERO F, CASTILLO-FERNáNDEZ O,

JIMéNEZ-JIMéNEZ G, et al. Cancer immunotherapyassociated hypophysitis [J]. Future Oncol, 2019, 15(27):

3159-69.

[5]SPAGNOLO C C, CAMPO I, CAMPENNì

A, et al. Challenges and pitfalls in the management of

endocrine toxicities from immune checkpoint inhibitors: a

case presentation of synchronous thyrotoxicosis and primary

adrenal insufficiency in a melanoma patient [J]. Hormones

(Athens), 2024.

[6]MIKAMI T, LIAW B, ASADA M, et al.

Neuroimmunological adverse events associated with immune

checkpoint inhibitor: a retrospective, pharmacovigilance study

using FAERS database [J]. J Neurooncol, 2021, 152(1): 135-

44.

[7]PARK H, HATABU H, RICCIUTI B, et al.

Immune-related adverse events on body CT in patients with

small-cell lung cancer treated with immune-checkpoint

inhibitors [J]. Eur J Radiol, 2020, 132: 109275.

[8]刘晓雯,龚静山,彭永佳,et al.免疫检查点抑制

剂相关不良反应影像评估[J].放射学实践,2023,38(07):

952-6.

[9]朱燕,龚艳君,吴世凯.免疫检查点抑制剂相关

心脏毒性反应的研究进展[J].临床肿瘤学杂志,2021,26

(04):373-9.

[10]BARINA A R, BASHIR M R, HOWARD B A,

et al. Isolated recto-sigmoid colitis: a new imaging pattern of

ipilimumab-associated colitis [J]. Abdom Radiol (NY), 2016,

41(2): 207-14.

[11]CHATTERJEE A, BIVAS B K, GEHANI A,

et al. Pembrolizumab-induced large duct cholangiopathy:

Diagnosis and follow.up imaging [J]. J Postgrad Med, 2021,

67(1): 43-5.

[12]HIRASAWA Y, YOSHIMURA K, MATSUI H,

et al. A case report on severe nivolumab-induced adverse

events similar to primary sclerosing cholangitis refractory to

immunosuppressive therapy [J]. Medicine (Baltimore), 2021,

100(23): e25774.

[13]PORCU M, SOLINAS C, MIGALI C, et al.

Immune Checkpoint Inhibitor-Induced Pancreatic Injury:

Imaging Findings and Literature Review [J]. Target Oncol,

2020, 15(1): 25-35.

[14]LIU J, SHI Y, LIU X, et al. Clinical characteristics

and outcomes of immune checkpoint inhibitor-induced

diabetes mellitus [J]. Transl Oncol, 2022, 24: 101473.

[15]ANDERSON M A, KHAULI M A, FURTADO F,

et al. Immunotherapy-related renal toxicity causes reversible

renal enlargement [J]. Abdom Radiol (NY), 2022, 47(9):

3301-7.

[16]LAU D, CORRIE P G, GALLAGHER F A. MRI

techniques for immunotherapy monitoring [J]. J Immunother

Cancer, 2022, 10(9).

[17]WU M, ZHANG Y, ZHANG Y, et al. Imagingbased Biomarkers for Predicting and Evaluating Cancer

Immunotherapy Response [J]. Radiol Imaging Cancer, 2019,

1(2): e190031.

[18]LARIMER B M. PET Imaging for Monitoring

Cellular and Immunotherapy of Cancer [J]. Cancer J, 2024,

30(3): 153-8.

[19]刘佳林,张皓.人工智能和影像组学在免疫检查

点抑制剂治疗非小细胞肺癌中的应用进展[J].临床肺科杂

志,2024,29(03):434-8.

[20]COLEN R R, FUJII T, BILEN M A, et al.

Radiomics to predict immunotherapy-induced pneumonitis:

proof of concept [J]. Invest New Drugs, 2018, 36(4): 601-7.

[21]CHEN X, SHEIKH K, NAKAJIMA E, et al.

Radiation Versus Immune Checkpoint Inhibitor Associated

Pneumonitis: Distinct Radiologic Morphologies [J].

Oncologist, 2021, 26(10): e1822-e32.


Refbacks

  • 当前没有refback。