Toripalimab is a PD-1 inhibitor classified as an immune checkpoint inhibitor, mainly used for the treatment of various malignant tumors (e.g., melanoma, nasopharyngeal carcinoma). Its drug-drug interactions are mainly related to immune system regulation and changes in efficacy or toxicity during combination therapy, and strict medical supervision is required for medication use.
I. Major Types of Drug-Drug Interactions
1. Immunosuppressive agents (e.g., glucocorticoids, cyclophosphamide)
Concomitant use may reduce the anti-tumor efficacy of toripalimab, requiring a balance of benefits and risks and efficacy monitoring.
Long-term or high-dose use of immunosuppressive agents may increase the risk of infection.
2. Other immune checkpoint inhibitors (e.g., CTLA-4 inhibitors)
Combination therapy may enhance immune-related adverse events (e.g., pneumonitis, hepatitis), requiring close monitoring.
3. Chemotherapy or targeted therapy
Concomitant use may improve efficacy through synergistic effects, but may also exacerbate myelosuppression or hepatic and renal dysfunction.
4. Live or attenuated vaccines
Vaccination during treatment may trigger severe immune reactions. Vaccination is recommended to be delayed for at least 3 months after the completion of treatment.
II. Special Precautions
1. Use of glucocorticoids
If glucocorticoids are needed to control immune-related adverse events, the dosage should be tapered gradually to discontinuation, and abrupt withdrawal should be avoided to prevent impacts on therapeutic efficacy.
2. Effects on hepatic enzymes (e.g., drugs metabolized by CYP450 enzymes)
There is no clear evidence that toripalimab affects hepatic enzyme activity. However, plasma drug concentration monitoring is still required when co-administered with CYP450-metabolized drugs (e.g., warfarin).
3. Chinese herbal medicines or health supplements
Some ingredients (e.g., echinacea, ginseng) may stimulate the immune system and increase the risk of adverse reactions.
III. Recommendations for Patients
Proactively inform the doctor of the complete medication history, including prescription drugs, over-the-counter drugs and health supplements.
Do not adjust the medication regimen independently, especially for immunosuppressive agents or chemotherapeutic drugs.
Undergo regular monitoring for immune-related adverse events (e.g., rash, diarrhea, abnormal liver function), and seek medical attention promptly if symptoms occur.
IV. Medical Guidance
Toripalimab is a prescription drug. An individualized regimen should be formulated based on the tumor type, stage and the patient’s overall condition. During treatment, follow-up visits and examinations such as blood routine, liver and renal function tests should be conducted strictly as instructed by the doctor to ensure the safety and efficacy of medication.
