Department of Thoracic Oncology, National Cancer Center East Hospital, Chiba, Japan.
Department of Thoracic Oncology, Kanagawa Cancer Center, Yokohama, Japan.
Expert Opin Drug Saf. 2021 May;20(5):537-547. doi: 10.1080/14740338.2021.1898584. Epub 2021 Mar 10.
: The development of immune checkpoint inhibitors (ICIs) has been a breakthrough in the treatment of several types of cancer. With the widespread use of ICIs in clinical practice, checkpoint inhibitor pneumonitis (CIP) is expected to increase and its management will pose a challenge for clinicians.: In this article, we review the incidence, associated risk factors, radiological patterns, clinical features, and management of CIP.: Several clinical trials assessing the efficacy and safety of combination treatments with various drugs and ICIs have been conducted. From the results of these trials, CIP is thought to be an acceptable side effect because the frequency of its development was slightly higher during combination therapies than during ICI monotherapies. However, the risk of developing CIP associated with combinations of chemotherapy and ICIs may be higher in the real world than in clinical trials. Because combinations of chemotherapy and ICIs are associated with increased toxicity, the proper management of immune-related adverse events is necessary to maximize the efficacy of the treatment.
免疫检查点抑制剂 (ICIs) 的发展是治疗多种癌症的突破。随着 ICI 在临床实践中的广泛应用,预计会增加检查点抑制剂性肺炎 (CIP) 的发病率,其管理将对临床医生构成挑战。本文综述了 CIP 的发生率、相关危险因素、影像学模式、临床特征和管理。已经进行了几项评估联合使用各种药物和 ICI 的治疗效果和安全性的临床试验。从这些试验的结果来看,CIP 被认为是一种可接受的副作用,因为在联合治疗中,其发生的频率略高于 ICI 单药治疗。然而,与化疗和 ICI 联合治疗相关的 CIP 发生风险在现实世界中可能高于临床试验。由于化疗和 ICI 的联合应用与毒性增加有关,因此需要对免疫相关不良事件进行适当的管理,以最大限度地提高治疗效果。