Immune checkpoint inhibitors (ICIs) are becoming first-line therapeutic options in oncology for more and more malignancies, including metastatic melanoma, non–small cell lung cancer, and kidney cancer, as well as adjuvant therapy for certain forms of melanoma. However, because of immune-related adverse events (irAEs), patients with preexisting autoimmune diseases (PADs) have been excluded from clinical trials of ICIs, even though many clinicians suspect these patients might benefit from these drugs. The main concern is that unleashing severe inflammatory and autoimmune toxicity might exacerbate a patient’s PAD or compromise their ability to tolerate ICI therapy.

中文翻译：

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免疫检查点抑制剂对已有自身免疫性疾病的患者可能是安全的

免疫检查点抑制剂 (ICI) 正成为越来越多恶性肿瘤的一线治疗选择，包括转移性黑色素瘤、非小细胞肺癌和肾癌，以及某些形式的黑色素瘤的辅助治疗。然而，由于免疫相关不良事件 (irAE)，已有自身免疫性疾病 (PAD) 的患者被排除在 ICI 的临床试验之外，尽管许多临床医生怀疑这些患者可能会从这些药物中受益。主要的担忧是释放严重的炎症和自身免疫毒性可能会加剧患者的 PAD 或损害他们耐受 ICI 治疗的能力。