Toripalimab (trade name: Tuoyi) is the first domestically produced PD-1 immune checkpoint inhibitor approved for market in China, developed by Junshi Biotechnology. It reactivates T cells to kill tumors by blocking the PD-1 pathway. Currently, it has been approved for 9 indications in China, covering multiple types of cancer such as melanoma, nasopharyngeal carcinoma, lung cancer, and kidney cancer.
1. Main adverse reactions (immune related)
Common (incidence rate ≥ 10%)
Fatigue, fever, rash, itching, diarrhea, nausea, decreased appetite, thyroid dysfunction (hypothyroidism/hyperthyroidism), and elevated liver enzymes.
Immune related adverse reactions that require high vigilance 2
Immune pneumonia: cough, shortness of breath, fever, immediate follow-up chest CT scan is required.
Immune hepatitis: significantly elevated transaminase and jaundice.
Immune colitis: persistent diarrhea, rectal bleeding, abdominal pain.
Immune myocarditis: palpitations, chest tightness, fatigue, although rare, can be fatal.
Pituitary inflammation/adrenal insufficiency: persistent weakness, hypotension, low sodium.
Principles of Handling
Mild to moderate: Suspend medication and treat with corticosteroids (prednisone 1-2mg/kg/day).
Severe: permanent discontinuation of medication, high-dose hormonal shock, and the addition of other immunosuppressive agents if necessary.
2. Practical Reminder
Pre medication evaluation
Check blood routine, liver and kidney function, thyroid function, myocardial enzymes, and lung imaging.
Exclude active autoimmune diseases, interstitial lung disease, and uncontrolled infections.
special populations
Prohibited during pregnancy, recommended to discontinue during lactation.
Active hepatitis B/C patients need to use under the control of antiviral treatment.
store
Store in the dark at 2-8 ℃ and do not freeze.
Costs and Medical Insurance
It has been included in the national medical insurance catalog, and the specific reimbursement ratio will be implemented according to local policies.
Immunotherapy takes effect relatively slowly and usually takes 2-4 cycles to show efficacy. It requires patient cooperation with doctors to complete the full course of treatment and cannot be interrupted on its own.
