西南医科大学学报2026，Vol.49Issue(3)：282-287,6.DOI:10.3969/j.issn.2096-3351.2026.03.004
免疫检查点抑制剂相关消化系统不良反应及处理
Management of Immune-Related Adverse Events in the Digestive System of Patients Treated with Immune Checkpoint Inhibitors
摘要
Abstract
In recent years,immune checkpoint inhibitors(ICI)have been emerging as standardized therapeutic agents against malignant tumors,while immune-related adverse events(IrAE)caused by ICI have become more common with their increased use.Excessive activation of the immune system due to"antigen sharing"and"immune off-target effect"may be the underling mechanisms of IrAE.Immune-related colitis and liver injury are the two most common IrAE in digestive system.Clinicians need to identify IrAE early and initiate treatment promptly.Most patients with IrAE respond well to appropriate supportive management,with symptoms relieved or less frequency to develop severe complications.Patients with severe IrAE(classified as grade≥3)should discontinue ICI and start treatment with immunosuppressive agents,typically corticosteroids.Patients with IrAE respond well to corticosteroids treat-ment.For corticosteroid-refractory IrAE,other immunomodulatory drugs should be applied.Generally,ICI rechallenge may be consid-ered for grade 2 IrAE,while cautious reintroduction might be an option for grade 3 IrAEs.In contrast,multiple guidelines recommend permanent discontinuation of ICI for patients experiencing grade 4 IrAEs.The decision to rechallenge with ICI should be based on a risk-benefit assessment,considering factors such as tumor status,availability of alternative treatment options beyond ICI,and the severity of previous IrAE.Patients who undergo ICI rechallenge require closer monitoring and follow-up to facilitate early identification and management of recurrent IrAE.关键词
免疫检查点抑制剂/消化系统不良反应/结肠炎/肝损伤/消化性溃疡Key words
Immune checkpoint inhibitors/Adverse reactions in digestive system/Colitis/Liver injury/Peptic ulcer分类
医药卫生引用本文复制引用
杨柳,刘伊涵,刘一诺,郭津生..免疫检查点抑制剂相关消化系统不良反应及处理[J].西南医科大学学报,2026,49(3):282-287,6.基金项目
国家自然科学基金(91129705,81070340,30570825) （91129705,81070340,30570825）
