Описание
Systemic corticosteroids such as dexamethasone can attenuate pembrolizumab's immune-stimulating anti-tumour activity by suppressing the immune effector responses that the checkpoint inhibitor relies on.
Механизм
Pembrolizumab blocks PD-1 on T cells, enhancing T-cell-mediated tumour killing; dexamethasone broadly suppresses T-cell activation, cytokine production, and effector function, potentially counteracting pembrolizumab's mechanism.
Клиническое значение
Retrospective analyses suggest that baseline corticosteroid use is associated with reduced objective response rates and progression-free survival in patients receiving anti-PD-1 therapy; the effect appears dose-dependent (>10 mg prednisone equivalent).
Тактика ведения
Use the lowest effective corticosteroid dose for the shortest duration when pembrolizumab is prescribed; reserve dexamethasone for irAE management using standard protocols; document the indication clearly.
Медицинский отказ от ответственности
This content is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making medication decisions.