1.宜春市人民医院药学部,江西 宜春 336000
2.宜春学院药学院,江西 宜春 336000
Received:05 February 2026,
Revised:2026-07-04,
Accepted:06 July 2026,
Online First:24 July 2026,
Published:30 July 2026
移动端阅览
李欣,易增兴.替雷利珠单抗致自身免疫性多内分泌腺综合征的文献分析[J].中国药房,2026,37(14):1880-1885.
LI Xin,YI Zengxing.Literature analysis of autoimmune polyglandular syndrome induced by tislelizumab[J].ZHONGGUO YAOFANG,2026,37(14):1880-1885.
李欣,易增兴.替雷利珠单抗致自身免疫性多内分泌腺综合征的文献分析[J].中国药房,2026,37(14):1880-1885. DOI: 10.6039/j.issn.1001-0408.2026.14.14.
LI Xin,YI Zengxing.Literature analysis of autoimmune polyglandular syndrome induced by tislelizumab[J].ZHONGGUO YAOFANG,2026,37(14):1880-1885. DOI: 10.6039/j.issn.1001-0408.2026.14.14.
目的
2
总结替雷利珠单抗致自身免疫性多内分泌腺综合征(APS)的发生特点及规律,为该药的安全使用及APS的治疗提供借鉴。
方法
2
以替雷利珠单抗及其同义词为主题词,系统检索中国知网、PubMed等国内外数据库,收集替雷利珠单抗致APS的个案报道,并进行描述性分析。
结果
2
共纳入12篇文献,涉及13例患者,其中男性10例、女性3例。患者的平均年龄为(61.62±10.43)岁,60岁以上老年人占46.15%;13例患者的原发疾病涉及非小细胞肺癌等8种实体瘤;1例患者存在糖尿病史,9例患者存在联合用药。所有患者均出现了2种内分泌腺损害,且多发生在用药的前10个周期内;相关内分泌腺损害主要表现为肾上腺-甲状腺、甲状腺-胰腺功能异常,首发表现以乏力、呕吐、恶心等非特异性症状为主;患者的相关异常指标(如促甲状腺激素、促肾上腺皮质激素等)与累及腺体密切相关,其中6例患者检出内分泌腺相关抗体阳性。所有患者均接受了停药、补液、纠正电解质等对症干预,其中9例好转、1例病情可控、3例内分泌腺功能丧失。
结论
2
APS是一种与替雷利珠单抗关系密切的罕见免疫相关性不良事件,具有起病急骤、症状多样但无特异性等特点,可造成腺体永久性损害。临床治疗与管理可遵循“分级诊疗、激素替代、多学科协作”的原则,做好基线评估、高危因素筛选、患者教育以及长期随访。
OBJECTIVE
2
To summarize the characteristics and patterns of autoimmune polyglandular syndrome (APS) induced by tislelizumab, and to provide guidance for the safe use of this drug and the treatment of APS.
METHODS
2
Using “tislelizumab” and its synonyms as search terms, a systematic search was conducted in domestic and international databases such as CNKI and PubMed to collect case reports of APS caused by tislelizumab, and descriptive analysis was performed.
RESULTS
2
A total of 12 publications were included, involving 13 patients (10 males and 3 females). The average age of the patients was (61.62±10.43) years, with 46.15% being elderly individuals over the age of 60. The underlying diseases of the 13 patients included 8 types of solid tumors, such as non-small cell lung cancer; 1 patient had a history of diabetes mellitus, and 9 patients were receiving concomitant medications. All patients experienced damage to two endocrine glands, with most cases occurring within the first 10 cycles of treatment. The associated endocrine gland damage primarily manifested as adrenal-thyroid and thyroid-pancreatic dysfunction, with initial symptoms dominated by nonspecific manifestations such as fatigue, vomiting, and nausea. The relevant abnormal laboratory markers (such as thyroid-stimulating hormone and adrenocorticotropic hormone) were closely associated with the affected glands, and positive antibodies related to endocrine glands were detected in 6 patients. All patients received symptomatic interventions, including drug discontinuation, fluid replacement, and electrolyte correction; among them, 9 patients improved, 1 patient’s condition was stabilized, and 3 patients experienced permanent loss of endocrine gland function.
CONCLUSIONS
2
APS is a rare immune-related adverse event closely associated with tislelizumab, characterized by sudden onset, diverse and non-specific symptoms, and can cause permanent damage to the glands. Clinical treatment and management should follow the principles of “tiered diagnosis and treatment, hormone replacement therapy, and multidisciplinary collaboration”, with a focus on thorough baseline assessment, screening for high-risk factors, patient education, and long-term follow-up.
王思渊 , 鲁辉 . PD-1/PD-L1类单抗药物在肿瘤治疗中的应用进展 [J ] . 中国生物制品学杂志 , 2023 , 36 ( 1 ): 105 - 111,118 .
Schönberger E , Švitek L , Grubišić B , et al . Beyond tumor immunity:the disruption of endocrine and infectious homeostasis by immune checkpoint inhibitors [J ] . Int J Mol Sci , 2025 , 26 ( 23 ): 11619 .
Awad O , Basma H , Masri R , et al . Autoimmune polyglandular syndrome Ⅱ:a case report [J ] . Cureus , 2024 : e52372 .
王雪 , 曹灵 , 罗娜 , 等 . 免疫检查点抑制剂相关自身免疫性多内分泌腺综合征2例报道及文献复习 [J ] . 现代肿瘤医学 , 2025 , 33 ( 7 ): 1154 - 1158 .
汪龙 , 张莉 , 朱玲娜 , 等 . 替雷利珠单抗致自身免疫性多内分泌腺病综合征1例 [J ] . 中国医院药学杂志 , 2024 , 44 ( 20 ): 2429 - 2432 .
庞婕 , 郭玉竹 , 骆继业 . 替雷利珠单抗致自身免疫性多内分泌腺综合征1例 [J ] . 医药导报 , 2024 , 43 ( 2 ): 308 - 311 .
高亦乐 , 乔田莉 , 蒋钰 , 等 . 免疫检查点抑制剂致迟发型糖尿病合并肾上腺皮质功能减退1例 [J ] . 中华内科杂志 , 2025 , 64 ( 11 ): 1111 - 1114 .
周忠艳 , 王柯欣 , 王艳芳 , 等 . 替雷利珠单抗致糖尿病酮症酸中毒和甲状腺功能减退 [J ] . 药物不良反应杂志 , 2025 , 27 ( 10 ): 629 - 631 .
张旋 , 高亮亮 , 邵亚丽 , 等 . 免疫检查点抑制剂相关多内分泌腺体功能异常1例 [J ] . 中国临床案例成果数据库 , 2025 , 7 ( 1 ): E0257 .
何秀 , 鄢欢 . 替雷利珠单抗致多内分泌腺功能减退1例并文献复习 [J ] . 医学理论与实践 , 2025 , 38 ( 17 ): 2978 - 2980 .
刘战涛 , 谌甜甜 , 余海英 , 等 . 替雷利珠单抗治疗膀胱癌致肾上腺危象1例 [J ] . 中国临床案例成果数据库 , 2025 , 7 ( 1 ): E1063 .
Li Z Y , Han K N , Li L , et al . Case report:tislelizumab-induced delayed-onset diabetic ketoacidosis and hypothyroidism in esophageal adenocarcinoma [J ] . Front Oncol , 2025 , 15 : 1642893 .
Liu M L , Fang S , Dai H R , et al . Prolonged progression-free survival in a patient with highly pretreated recurrent ovarian cancer after developing multisystem immune-related adverse events:a case report and literature review [J ] . Case Rep Oncol , 2025 , 18 ( 1 ): 912 - 919 .
Baek J H . Adrenal insufficiency development during chemotherapy plus anti-programmed death receptor-1 monoclonal antibody (tislelizumab) therapy in patients with advanced gastric cancer:case series [J ] . J Yeungnam Med Sci , 2022 , 39 ( 1 ): 62 - 66 .
Wang J Y , Lan H R , Mao X W , et al . Pituitary-adrenal axis dysfunction induced by tislelizumab immunotherapy for non-small cell lung cancer:a case series and literature review [J ] . BMC Pulm Med , 2024 , 24 ( 1 ): 327 .
Basek A , Jakubiak G K , Cieślar G , et al . Life-threatening endocrinological immune-related adverse events of immune checkpoint inhibitor therapy [J ] . Cancers , 2023 , 15 ( 24 ): 5786 .
解宝仙 , 王璐 , 高玉香 . 替雷利珠单抗致药品不良反应病例文献分析 [J ] . 中国药业 , 2025 , 34 ( 13 ): 129 - 136 .
Haanen J , Obeid M , Spain L , et al . Management of toxicities from immunotherapy:ESMO clinical practice guideline for diagnosis,treatment and follow-up [J ] . Ann Oncol , 2022 , 33 ( 12 ): 1217 - 1238 .
Shi Y , Shen M , Zheng X Q , et al . ICPis-induced autoimmune polyendocrine syndrome type 2:a review of the literature and a protocol for optimal management [J ] . J Clin Endocrinol Metab , 2020 , 105 ( 12 ): dgaa553 .
Zhao Z , Wang X F , Bao X Q , et al . Autoimmune poly-endocrine syndrome induced by immune checkpoint inhibitors:a systematic review [J ] . Cancer Immunol Immunother , 2021 , 70 ( 6 ): 1527 - 1540 .
刘明 , 张志伟 . 免疫检查点抑制剂治疗肿瘤的作用机制及其免疫相关不良反应的研究进展 [J ] . 免疫学杂志 , 2021 , 37 ( 11 ): 1007 - 1012 .
Hong Y , Feng Y C , Sun H Z , et al . Tislelizumab uniquely binds to the CC′ loop of PD-1 with slow-dissociated rate and complete PD-L1 blockage [J ] . FEBS Open Bio , 2021 , 11 ( 3 ): 782 - 792 .
Barroso-Sousa R , Barry W T , Garrido-Castro A C , et al . Incidence of endocrine dysfunction following the use of different immune checkpoint inhibitor regimens:a sys-tematic review and meta-analysis [J ] . JAMA Oncol , 2018 , 4 ( 2 ): 173 - 182 .
Ning P , Liu S L , Cao H Y . Rare,late onset of immune checkpoint inhibitor-induced type 1 diabetes mellitus in a patient with small-cell lung cancer treated with serplulimab:a case report and review of the literature [J ] . J Med Case Rep , 2024 , 18 ( 1 ): 51 .
Thompson J A , Schneider B J , Brahmer J , et al . Management of immunotherapy-related toxicities,version 1,2022,NCCN clinical practice guidelines in oncology [J ] . J Natl Compr Canc Netw , 2022 , 20 ( 4 ): 387 - 405 .
中华医学会内分泌学分会免疫内分泌学组 . 免疫检查点抑制剂引起的内分泌系统免疫相关不良反应专家共识:2020 [J ] . 中华内分泌代谢杂志 , 2021 , 37 ( 1 ): 1 - 16 .
Percik R , Shoenfeld Y . Check point inhibitors and autoimmunity:why endocrinopathies and who is prone to? [J ] . Best Pract Res Clin Endocrinol Metab , 2020 , 34 ( 1 ): 101411 .
Abraham P E , Johnson D B . Long-term toxicities of immune checkpoint inhibitors [J ] . Drugs , 2025 , 85 ( 12 ): 1535 - 1549 .
Iwama S , Kobayashi T , Arima H . Management,biomar-kers and prognosis in people developing endocrinopathies associated with immune checkpoint inhibitors [J ] . Nat Rev Endocrinol , 2025 , 21 ( 5 ): 289 - 300 .
Arima H , Iwama S , Inaba H , et al . Management of immune-related adverse events in endocrine organs induced by immune checkpoint inhibitors:clinical guidelines of the Japan Endocrine Society [J ] . Endocr J , 2019 , 66 ( 7 ): 581 - 586 .
Kidawara Y , Kadoya M , Kakutani-Hatayama M , et al . A case in which HLA-DR4 is involved in the development of complex immune-related endocrinological adverse events following combination therapy with nivolumab and ipilimumab [J ] . Case Rep Endocrinol , 2024 , 2024 : 4662803 .
0
Views
0
下载量
0
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution
京公网安备11010802024621
