期刊
CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY
卷 157, 期 -, 页码 -出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.critrevonc.2020.103176
关键词
Cancer; Immunotherapy; Glucocorticoids; Immune-checkpoint blockade; Palliative care
Glucocorticoids play a crucial role in managing immune-related adverse events and symptoms in cancer patients. The purpose of glucocorticoid administration may impact the survival outcomes of cancer patients undergoing immune-checkpoint inhibitor treatment.
Immune-checkpoint inhibitors significantly reshaped treatment landscapes in several solid tumors. Concurrently with disease-oriented therapies, cancer patients often require proper management of drug-related adverse events and/or cancer-related symptoms. Glucocorticoids (GC) are a cornerstone of symptom management in advanced cancer care and in the management of immune-related adverse events (irAEs) due to immune-modulating therapies. Moreover, GC are often administered in patients with autoimmune diseases (AID), either alone or in combination with other treatments. While handling of irAEs with GC is supported by multiple guidelines, it is unclear whether GC administration because of pre-existing AID or because of palliative needs is associated with inferior outcomes in cancer patients treated with immune-checkpoint inhibitors (ICIs). When globally considered, the available evidence seems to orient towards less favorable survival outcomes when GC administration is driven by a palliative intent. Conversely, steroid administration for non-palliative intent seems to be associated with stable or negligibly reduced survival outcomes.
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