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[肺癌与类风湿关节炎。一项跨学科挑战]

[Lung cancer and rheumatoid arthritis. An interdisciplinary challenge].

作者信息

Rubbert-Roth A, Zander T, Kneitz C, Baerwald C, Wirtz H, Witt C

机构信息

Klinik I für Innere Medizin, Universitätsklinik Köln, Kerpenerstr. 62, 50924, Köln, Deutschland.

Südstadtklinikum Rostock, Rostock, Deutschland.

出版信息

Z Rheumatol. 2016 Feb;75(1):47-53. doi: 10.1007/s00393-016-0043-0.

Abstract

Lung cancer is a frequently occurring disease, particularly in the elderly; however, within the last 10 years the pharmaceutical treatment of lung cancer has been significantly improved. Due to a better understanding of the pathophysiological events and the identification of molecular subgroups of lung tumors, new therapeutic drugs have been developed that significantly prolong survival of patients with the respective molecular pattern. In particular immunotherapeutic agents, such as programmed death-ligand 1 (PD-L1) and programmed death 1 (PD1) antibodies have shown promising clinical results in a subgroup of lung cancer patients. Due to the high incidence of both lung cancer and rheumatic diseases they often occur together, which necessitates an interdisciplinary management. The success of improved therapy of lung cancer has led to a greater focus on the treatment of comorbidities; however, interventions into the immune system by immune checkpoint inhibitors can lead to new challenges when an autoimmune disease is simultaneously present. The possibility of an effective screening for lung cancer in the future also presents the prospect of an improvement in mortality, which raises the question of the optimal monitoring of patients with rheumatoid arthritis (RA) under immunosuppressive therapy. The aim of this review is to discuss the interaction between lung cancer and RA with respect to the currently available data.

摘要

肺癌是一种常见疾病,尤其在老年人中多发;然而,在过去10年里,肺癌的药物治疗有了显著改善。由于对病理生理事件有了更深入的了解,以及对肺肿瘤分子亚群的识别,已开发出新型治疗药物,可显著延长具有相应分子模式的患者的生存期。特别是免疫治疗药物,如程序性死亡配体1(PD-L1)和程序性死亡1(PD1)抗体,在一部分肺癌患者中已显示出有前景的临床效果。由于肺癌和风湿性疾病的高发病率,它们常常同时出现,这就需要进行多学科管理。肺癌治疗改善的成功使得人们更加关注合并症的治疗;然而,当同时存在自身免疫性疾病时,免疫检查点抑制剂对免疫系统的干预会带来新的挑战。未来有效筛查肺癌的可能性也为死亡率的改善带来了希望,这就引发了在免疫抑制治疗下对类风湿关节炎(RA)患者进行最佳监测的问题。本综述的目的是根据现有数据讨论肺癌与RA之间的相互作用。

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