From the Departments of Pulmonary and Critical Care Medicine and Hematology and Oncology Medicine, Marshall University, Joan C. Edwards School of Medicine, the Huntington Veterans Administration Medical Center, Huntington, West Virginia, and the MetroHealth System Campus of Case Western Reserve University, Cleveland, Ohio.
South Med J. 2021 Sep;114(9):614-619. doi: 10.14423/SMJ.0000000000001295.
The development of immune checkpoint inhibitors (ICIs) has changed the treatment paradigm for cancer. The ICIs nivolumab, pembrolizumab, and cemiplimab target programmed cell death protein 1, and durvalumab, avelumab, and atezolizumab target programmed death ligand 1. Ipilimumab targets cytotoxic T lymphocyte-associated antigen-4. Used as monotherapy or in combination, they have shown remarkable efficacy in melanoma, lung cancer, and many other solid tumors, and indications continue to evolve. These checkpoint inhibitors are typically well tolerated; however, they may cause immune-mediated adverse effects, resulting in inflammation of any organ system. Pulmonary toxicity is vital to recognize, and it can be more challenging to diagnose in patients with lung cancer, given the nature of the disease course and treatment.
免疫检查点抑制剂(ICIs)的发展改变了癌症的治疗模式。ICI 药物纳武利尤单抗、帕博利珠单抗和西米普利单抗针对程序性死亡蛋白 1,而度伐鲁单抗、avelumab 和阿替利珠单抗针对程序性死亡配体 1。Ipilimumab 则针对细胞毒性 T 淋巴细胞相关抗原 4。无论是单药治疗还是联合治疗,这些药物在黑色素瘤、肺癌和许多其他实体瘤中都显示出了显著的疗效,并且适应证还在不断扩展。这些检查点抑制剂通常具有良好的耐受性;然而,它们可能会引起免疫介导的不良反应,导致任何器官系统的炎症。肺毒性是需要识别的关键问题,由于疾病进程和治疗的性质,在肺癌患者中诊断起来可能更具挑战性。