면역항암치료의 부작용 관리: 호흡계와 신경계를 중심으로 (Management of the adverse effects of cancer immunotherapy with a focus on the respiratory and nervous systems)

서지정보

· 발행기관 : 대한의사협회
· 수록지 정보 : 대한의사협회지 / 66권 / 2호 / 116 ~ 122페이지
· 저자명 : 박송이

초록

Background: The incidence of adverse toxic reactions to immunotherapy using immune checkpoint inhibitors is 2-10% in the respiratory system and 3.9% to 12% in the neurologic system. The severity of adverse effects increases when combined immunotherapeutic agents are administered.
Current Concepts: In cases of high-grade toxicity, it is important to discontinue immunotherapy immediately.
In cases of grade 3 to 4 toxicity, immunosuppressive corticosteroid therapy is the first-line treatment. Short-term steroid treatment does not affect anti-tumor efficacy. It is thus necessary to use steroids for an appropriate period then carefully taper the steroid dose to prevent recurrence. If no improvement is achieved within 48-72 hours after the administration of steroids, it is essential to initiate multidisciplinary treatment involving related departments and add immunosuppressive drugs. If the patient is administrated immunotherapy again, it may be necessary to permanently discontinue the immunotherapy depending on the toxicity grade that first occurred.
Discussion and Conclusion: The primary goals for effective management of immunotherapy-related adverse events are early recognition of symptoms and immediate treatment.

영어초록

Background: The incidence of adverse toxic reactions to immunotherapy using immune checkpoint inhibitors is 2-10% in the respiratory system and 3.9% to 12% in the neurologic system. The severity of adverse effects increases when combined immunotherapeutic agents are administered.
Current Concepts: In cases of high-grade toxicity, it is important to discontinue immunotherapy immediately.
In cases of grade 3 to 4 toxicity, immunosuppressive corticosteroid therapy is the first-line treatment. Short-term steroid treatment does not affect anti-tumor efficacy. It is thus necessary to use steroids for an appropriate period then carefully taper the steroid dose to prevent recurrence. If no improvement is achieved within 48-72 hours after the administration of steroids, it is essential to initiate multidisciplinary treatment involving related departments and add immunosuppressive drugs. If the patient is administrated immunotherapy again, it may be necessary to permanently discontinue the immunotherapy depending on the toxicity grade that first occurred.
Discussion and Conclusion: The primary goals for effective management of immunotherapy-related adverse events are early recognition of symptoms and immediate treatment.

참고자료

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