Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.
Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.
Chest. 2019 Apr;155(4):e79-e82. doi: 10.1016/j.chest.2018.12.002.
Immune checkpoint inhibitors have revolutionized cancer therapy. As the use of checkpoint inhibitors becomes widespread, the early recognition and treatment of their unique spectrum of adverse effects, called immune-related adverse events, become critical. Perhaps the most significant of these is the pulmonary toxicity currently described as "pneumonitis." However, little is known about the effects of immune checkpoint inhibitors on preexisting interstitial lung disease. We present a case of subclinical hypersensitivity pneumonitis that was exacerbated by pembrolizumab, a programmed cell death-1 inhibitor. This case illustrates a new immune-related adverse event and suggests that exacerbation of preexisting interstitial lung disease is a potential pulmonary toxicity from immune checkpoint inhibitor therapy.
免疫检查点抑制剂改变了癌症治疗格局。随着检查点抑制剂的广泛应用，早期识别和治疗其独特的不良反应谱（称为免疫相关不良反应）变得至关重要。其中最重要的可能是目前被描述为“肺炎”的肺毒性。然而，对于免疫检查点抑制剂对先前存在的间质性肺病的影响知之甚少。我们报告了一例程序性细胞死亡-1 抑制剂帕博利珠单抗治疗导致的亚临床型过敏性肺炎病例。该病例说明了一种新的免疫相关不良反应，并提示免疫检查点抑制剂治疗可能会加重先前存在的间质性肺病。
