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免疫检查点阻断后结核再激活致小细胞肺癌长期缓解：1 例报告

Long-term remission of small cell lung cancer after reactivation of tuberculosis following immune-checkpoint blockade: A case report.

机构信息

Department of Medical Oncology and Pneumology, University Hospital Tuebingen, Tuebingen, Germany.

Cluster of Excellence iFIT (EXC 2180) "Image-Guided and Functionally Instructed Tumor Therapies", University of Tuebingen, Tuebingen, Germany.

出版信息

Thorac Cancer. 2021 Mar;12(5):699-702. doi: 10.1111/1759-7714.13821. Epub 2021 Jan 17.

DOI:10.1111/1759-7714.13821
PMID:33458956
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7919119/
Abstract

Immune-checkpoint inhibitors (ICIs) provide a promising treatment option for advanced tumors including small cell lung cancer (SCLC). Nevertheless, in addition to immune-related adverse events (irAEs), an increased risk of infection including tuberculosis has been previously described. Here, we report a case of long-term remission of a patient with SCLC after reactivation of lung tuberculosis following ICI therapy. Our case illustrates the complexity of ICI-associated immune modulation in tuberculosis. Since new lesions in lung cancer patients are commonly associated with tumor progression, infections with mycobacterial tuberculosis may be underdiagnosed in lung cancer.

摘要

免疫检查点抑制剂 (ICIs) 为包括小细胞肺癌 (SCLC) 在内的晚期肿瘤提供了一种有前途的治疗选择。然而，除了免疫相关不良事件 (irAEs) 之外，先前还描述了感染包括结核病在内的风险增加。在这里，我们报告了一例 SCLC 患者在 ICI 治疗后肺结核复发后长期缓解的病例。我们的病例说明了 ICI 相关免疫调节在结核病中的复杂性。由于肺癌患者的新病变通常与肿瘤进展相关，因此肺癌患者中分枝杆菌结核病的感染可能被漏诊。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c436/7919119/460617a435e5/TCA-12-699-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c436/7919119/460617a435e5/TCA-12-699-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c436/7919119/460617a435e5/TCA-12-699-g001.jpg

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本文引用的文献

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Lung Cancer. 2019 Nov;137:31-37. doi: 10.1016/j.lungcan.2019.08.024. Epub 2019 Aug 22.
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Reactivation of tuberculosis in cancer patients following administration of immune checkpoint inhibitors: current evidence and clinical practice recommendations.免疫检查点抑制剂治疗后癌症患者结核病的再激活：当前证据和临床实践建议。
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真实世界中小细胞肺癌（SCLC）治疗的疗效和耐受性：系统文献回顾（SLR）。
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