免疫检查点抑制剂相关感染的诊断和管理建议。
Recommendation for the diagnosis and management of immune checkpoint inhibitor related infections.
机构信息
Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases (BZ0447), Beijing, China.
出版信息
Thorac Cancer. 2020 Mar;11(3):805-809. doi: 10.1111/1759-7714.13313. Epub 2020 Jan 22.
Immune checkpoint inhibitors (ICIs) have been widely used in the management of malignant tumors. Programmed death 1 (PD-1)/PD-1 ligand (PD-L1) inhibitors have been introduced to treat non-small cell lung cancer (NSCLC) in recent years. Currently, PD-1/PD-L1 inhibitors are considered to have minor side effects and do not independently increase the risk of infection. However, they may cause immune-related adverse events (irAEs) that require immunosuppressive therapy with corticosteroids and/or immunosuppressants, leading to opportunistic infections. Furthermore, there have been reports describing reactivation of chronic/latent infections without irAEs or having received immunosuppressants. Thus, immune checkpoint inhibitor related infections have received more attention worldwide. In this paper, we review available clinical data, describe the potential mechanism, and propose recommendations for the diagnosis and clinical management of PD-1/PD-L1 inhibitor-related infections.
免疫检查点抑制剂（ICIs）已广泛用于恶性肿瘤的治疗。近年来，程序性死亡受体 1（PD-1）/PD-1 配体（PD-L1）抑制剂已被引入用于治疗非小细胞肺癌（NSCLC）。目前，PD-1/PD-L1 抑制剂被认为具有较小的副作用，并且不会独立增加感染的风险。但是，它们可能导致需要使用皮质类固醇和/或免疫抑制剂进行免疫抑制治疗的免疫相关不良事件（irAEs），从而导致机会性感染。此外，已有报道描述了在没有 irAEs 或未使用免疫抑制剂的情况下慢性/潜伏感染的再激活。因此，免疫检查点抑制剂相关感染在全球范围内受到了更多关注。本文我们综述了现有的临床数据，描述了潜在的机制，并提出了用于 PD-1/PD-L1 抑制剂相关感染的诊断和临床管理的建议。
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