肿瘤免疫治疗相关不良反应管理课件.ppt

,肿瘤免疫治疗相关不良反应管理,目录肿瘤免疫治疗不良治疗不良反应概述不良反应相关指南解读临床应用的要点及难点,目录肿瘤免疫治疗不良治疗不良反应概述不良反应相关指南解读临床应用的要点及难点,免疫正常化莫定了PD-1/PD-L1抑制剂临床免疫治疗的基石地位A Paradigm Shift in Cancer Immunotherapy.rom Enhancement to normalizationCellhtts9ydog/101016/c1201809.035,CTLA4抗体的作用机制A sinlrmny1.阻断竞争抑制姐断T细孢上CILA-4与B7分子的结合,减少CTLA-4下游抑制信号,恢复D28介导T的细胞活性,增加T细胞漫润2耗竭Treg抗体还能与肿瘤微环境中巨噬细胞的F受体反应,介导细跑吞噬/杀伤作用(AD C/ADCP),选择性消除翀瘤病变内的eg细胞。该作用依赖于肿霤微环境中表达Fc受体的巨噬细跑的存在),为什么正常化更重要增强治疗批准的瘤种受限,长期没有突啵增强治疗的有效率低,毒性高Enhancers FDA-approveNormalizersapproved:indicationsHairy leukemiam然身单.24x457题MelanomaB cell lymphoma/eufemiaMl-CILA4TaGr55,w2)的e四1m耍5(任为3因b的m45间9nhMerkel cell carcinomaGastrie cancerk和D1NSl-high cancerLivercancer1firW36的2Cervicalrm1四5e0:和4a四得mua,免疫相关不良反应(iAE)的发生机制不同 checkpoint抑制剂Elood wsy:临床毒谱免疫学效应的不一致差异大回/CLA4els ingo tumoursHierarchy of co-inhibitory receptorsRecogitionCTLA-4PD-1Tim-3TIGITNATURE BIOTECHNOLOGY VOLUME 34 NUMBER 10 OCTOBER,免疫相关不良反应(iAE)的发生机制:免疫系统的激活活化的T细泡攻击正自身抗体的加了甲状功神皮和白风Infant ry knesCTLA4异位表达引三上功不全炎症性细孢起的ADCC因子的塔加,目录肿瘤免疫治疗不良治疗不良反应概述不良反应相关指南解读临床应用的要点及难点,随着IO应用増多,欧美副反应管理指南/共识陆续发表Management of toxicitiesmmunotherapy2019.05ESMO NSMO Clinical Practice Guidelines for diagnosistreatment and follow-upAND G2019.SITC Managing toxicities associated withimmune checkpoint inhibitors:consens2018.02NCCNpComprehensive NCCN Guidelines Version 1.2019Hetwerk.Management of Immunotherapy-Related Toxicitiesanagement of Immune-Related Adverse Events in Patients201802ASc0preated with Immune Checkpoint Inhibitor TherapAmerican Society of Clinical Oncology Clinical,