Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University, Baltimore, MD, USA.
Curr Oncol Rep. 2020 May 16;22(6):56. doi: 10.1007/s11912-020-00920-z.
Checkpoint inhibitor pneumonitis (CIP) is a toxicity of immune checkpoint blockade (ICB) that can be highly morbid and at times fatal. Here, we review the proposed biologic mechanisms of CIP, epidemiology and risk factors for CIP development, diagnostic work-up and management strategies for CIP, and future directions of CIP research.
CIP incidence appears to be greater in real-world populations and may continue to rise as FDA approvals for ICB continue to expand to multiple malignancies. Multiple retrospective studies and case series have identified potential risk factors for CIP. Several society guidelines have helped to unify the classification of CIP severity and standardize treatment approaches but significant gaps remain, including formal validated diagnostic criteria for CIP. While significant strides have been made in enhancing the knowledge and management of CIP, ongoing research is needed to continue to advance our understanding of the biologic underpinnings of CIP, as well as optimize diagnostic and management strategies for this potentially devastating toxicity.
检查点抑制剂性肺炎（CIP）是免疫检查点抑制剂（ICB）的一种毒性反应，可导致严重疾病甚至致命。本文综述了 CIP 的生物学机制、CIP 的发病机制和危险因素、CIP 的诊断和管理策略，以及 CIP 研究的未来方向。
CIP 的发病率在真实世界人群中似乎更高，随着 FDA 批准 ICB 扩展到多种恶性肿瘤，发病率可能会继续上升。多项回顾性研究和病例系列研究确定了 CIP 的潜在危险因素。一些学会指南有助于统一 CIP 严重程度的分类和标准化治疗方法，但仍存在很大差距，包括 CIP 的正式验证诊断标准。虽然在提高对 CIP 的认识和管理方面取得了重大进展，但仍需要开展进一步的研究，以加深对 CIP 生物学基础的理解，并优化这种潜在致命毒性的诊断和管理策略。
