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新冠疫情时代癌症治疗中的药物相关性肺炎

Drug-Related Pneumonitis in Cancer Treatment during the COVID-19 Era.

作者信息

Cherri Sara, Noventa Silvia, Fanelli Martina, Calandra Giulio, Prochilo Tiziana, Bnà Claudio, Savelli Giordano, Zaniboni Alberto

机构信息

Unit of Medical Oncology, Department of Oncology, Fondazione Poliambulanza, 25124 Brescia, Italy.

Medical Oncology Unit, University Hospital of Modena, 41124 Modena, Italy.

出版信息

Cancers (Basel). 2021 Mar 2;13(5):1052. doi: 10.3390/cancers13051052.

Abstract

Interstitial lung disease is recognized as a group of diseases with a different etiopathogenesis characterized by chronic lung inflammation with the accumulation of inflammatory cells, lymphocytes and macrophages, and the consequent release of proinflammatory cytokines. Various degrees of pulmonary fibrosis can be associated with this inflammatory condition. Interstitial lung disease related to oncological drugs is a relevant problem in clinical practice. The etiopathogenetic mechanisms underlying this adverse event are not completely known but can be partly explained by the mechanism of action of the drug involved. Therefore, knowledge of the relevance of this potentially fatal adverse event supported by the reported safety data of pivotal studies becomes fundamental in the management of patients. The prompt diagnosis of drug-related pneumonia and the consequent differential diagnosis with other forms of pneumonia allow a rapid suspension of treatment and the establishment of an immunosuppressive treatment if necessary. In the context of the health emergency related to SARS CoV2 infection and COVID-19-related interstitial lung disease, such knowledge holds decisive relevance in the conscious choice of cancer treatments. Our intent was to describe the oncological drugs most correlated with this adverse event by reporting, where possible, the percentages of insurgency in pivotal studies to provide an overview and therefore promote greater awareness of this important toxicity related to oncological treatment.

摘要

间质性肺疾病被认为是一组病因发病机制不同的疾病,其特征为慢性肺部炎症伴炎症细胞、淋巴细胞和巨噬细胞积聚,以及随之而来的促炎细胞因子释放。不同程度的肺纤维化可能与这种炎症状态相关。与肿瘤药物相关的间质性肺疾病是临床实践中的一个相关问题。这一不良事件背后的病因发病机制尚不完全清楚,但部分可由所涉药物的作用机制解释。因此,根据关键研究报告的安全性数据了解这一潜在致命不良事件的相关性,在患者管理中变得至关重要。药物相关性肺炎的及时诊断以及与其他形式肺炎的鉴别诊断,有助于迅速停止治疗,并在必要时建立免疫抑制治疗。在与SARS-CoV2感染和COVID-19相关的间质性肺疾病有关的卫生紧急情况下,此类知识在癌症治疗的明智选择中具有决定性意义。我们的目的是通过尽可能报告关键研究中的发生率百分比,来描述与这一不良事件最相关的肿瘤药物,以提供一个概述,从而提高对这种与肿瘤治疗相关的重要毒性的认识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2da6/7958630/da1a495fac98/cancers-13-01052-g001.jpg

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