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尼达尼布治疗老年非小细胞肺癌患者类固醇难治性免疫检查点抑制剂相关肺炎 1 例并文献复习

Nintedanib in an elderly non-small-cell lung cancer patient with severe steroid-refractory checkpoint inhibitor-related pneumonitis: A case report and literature review.

机构信息

Department of Respiratory and Critical Care Medicine, The First Hospital of China Medical University, Shenyang, China.

The First Clinical College, China Medical University, Shenyang, China.

出版信息

Front Immunol. 2023 Jan 10;13:1072612. doi: 10.3389/fimmu.2022.1072612. eCollection 2022.


DOI:10.3389/fimmu.2022.1072612
PMID:36703957
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9872202/
Abstract

Immune checkpoint inhibitors tremendously improve cancer prognosis; however, severe-grade immune-related adverse events may cause premature death. Current recommendations for checkpoint inhibitor-related pneumonitis (CIP) treatment are mainly about immunosuppressive therapy, and anti-fibrotic agents are also needed, especially for patients with poor response to corticosteroids and a longer pneumonitis course. This is because fibrotic changes play an important role in the pathological evolution of CIP. Here, we report a case demonstrating that nintedanib is a promising candidate drug for CIP management or prevention, as it has potent anti-fibrotic efficacy and a safety profile. Moreover, nintedanib could partially inhibit tumor growth in patients with non-small-cell lung cancer, and its efficacy can be improved in combination with other anti-tumor therapies.

摘要

免疫检查点抑制剂极大地改善了癌症预后;然而,严重级别的免疫相关不良反应可能导致过早死亡。目前针对免疫检查点抑制剂相关肺炎(CIP)治疗的建议主要是免疫抑制治疗,还需要使用抗纤维化药物,特别是对于对皮质类固醇反应不佳和肺炎病程较长的患者。这是因为纤维化改变在 CIP 的病理演变中起着重要作用。在这里,我们报告了一个病例,表明尼达尼布是一种有前途的 CIP 管理或预防候选药物,因为它具有强大的抗纤维化疗效和安全性。此外,尼达尼布可以部分抑制非小细胞肺癌患者的肿瘤生长,并且与其他抗肿瘤疗法联合使用可以提高其疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69f3/9872202/2144e1d53db9/fimmu-13-1072612-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69f3/9872202/f409090a8b58/fimmu-13-1072612-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69f3/9872202/bf3ca9b97dba/fimmu-13-1072612-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69f3/9872202/042d54c0242b/fimmu-13-1072612-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69f3/9872202/44cb1785d248/fimmu-13-1072612-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69f3/9872202/780c7903e85b/fimmu-13-1072612-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69f3/9872202/f3bc9dcc5c9e/fimmu-13-1072612-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69f3/9872202/2144e1d53db9/fimmu-13-1072612-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69f3/9872202/f409090a8b58/fimmu-13-1072612-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69f3/9872202/bf3ca9b97dba/fimmu-13-1072612-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69f3/9872202/042d54c0242b/fimmu-13-1072612-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69f3/9872202/44cb1785d248/fimmu-13-1072612-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69f3/9872202/780c7903e85b/fimmu-13-1072612-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69f3/9872202/f3bc9dcc5c9e/fimmu-13-1072612-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/69f3/9872202/2144e1d53db9/fimmu-13-1072612-g007.jpg

相似文献

[1]
Nintedanib in an elderly non-small-cell lung cancer patient with severe steroid-refractory checkpoint inhibitor-related pneumonitis: A case report and literature review.

Front Immunol. 2022

[2]
Nintedanib allows retreatment with atezolizumab of combined non-small cell lung cancer/idiopathic pulmonary fibrosis after atezolizumab-induced pneumonitis: a case report.

BMC Pulm Med. 2019-8-22

[3]
Successful treatment of steroid-refractory immune checkpoint inhibitor-related pneumonitis with triple combination therapy: a case report.

Cancer Immunol Immunother. 2020-5-15

[4]
High mortality and poor treatment efficacy of immune checkpoint inhibitors in patients with severe grade checkpoint inhibitor pneumonitis in non-small cell lung cancer.

Thorac Cancer. 2019-9-3

[5]
Case Report: Nintedanib for Pembrolizumab-Related Pneumonitis in a Patient With Non-Small Cell Lung Cancer.

Front Oncol. 2021-6-18

[6]
Tumor invasion in the central airway is a risk factor for early-onset checkpoint inhibitor pneumonitis in patients with non-small cell lung cancer.

Thorac Cancer. 2020-12

[7]
Pneumonitis in Non-Small Cell Lung Cancer Patients Receiving Immune Checkpoint Immunotherapy: Incidence and Risk Factors.

J Thorac Oncol. 2018-9-26

[8]
Clinical outcomes and risk factor of immune checkpoint inhibitors-related pneumonitis in non-small cell lung cancer patients with chronic obstructive pulmonary disease.

BMC Pulm Med. 2022-12-1

[9]
Cytomegalovirus infection as an underestimated trigger for checkpoint inhibitor-related pneumonitis in lung cancer: a retrospective study.

Clin Transl Oncol. 2021-2

[10]
[Clinical features and prognostic analysis of checkpoint inhibitor pneumonitis in patients with non-small cell lung cancer].

Zhonghua Jie He He Hu Xi Za Zhi. 2024-3-12

引用本文的文献

[1]
Heterogeneity of Checkpoint Inhibitor-Associated Pneumonitis: A Multicenter Study on Inflammatory Subtypes and Clinical Outcomes.

Cancer Med. 2025-7

[2]
Sepsis-related immune signature C3 in endometrial carcinoma: implications for prognosis, tumor progression through bioinformatics and experimental validation.

Mol Biol Rep. 2025-5-20

[3]
Cyclosporine successfully treats steroid-resistant checkpoint inhibitor-related pneumonitis: a case report.

BMC Pulm Med. 2024-11-21

本文引用的文献

[1]
Single-cell transcriptomics identifies pathogenic T-helper 17.1 cells and pro-inflammatory monocytes in immune checkpoint inhibitor-related pneumonitis.

J Immunother Cancer. 2022-9

[2]
Establishment and validation of nomogram for predicting immuno checkpoint inhibitor related pneumonia.

BMC Pulm Med. 2022-9-1

[3]
Proposed clinical phases for the improvement of personalized treatment of checkpoint inhibitor-related pneumonitis.

Front Immunol. 2022

[4]
Safety, recommended dose, efficacy and immune correlates for nintedanib in combination with pembrolizumab in patients with advanced cancers.

J Exp Clin Cancer Res. 2022-7-7

[5]
Immune check-point inhibitor-related pneumonitis: acute lung injury with rapid progression and organising pneumonia with less severe clinical disease.

Histopathology. 2022-12

[6]
Comprehensive Analysis of the Immune Microenvironment in Checkpoint Inhibitor Pneumonitis.

Front Immunol. 2021

[7]
Targeting the PDGF/PDGFR signaling pathway for cancer therapy: A review.

Int J Biol Macromol. 2022-3-31

[8]
Clinical Outcomes of Immune Checkpoint Inhibitor Therapy in Patients With Advanced Non-small Cell Lung Cancer and Preexisting Interstitial Lung Diseases: A Systematic Review and Meta-analysis.

Chest. 2022-6

[9]
Real-World Efficacy of Nintedanib Plus Docetaxel After Progression on Immune Checkpoint Inhibitors: Results From the Ongoing, Non-interventional VARGADO Study.

Clin Oncol (R Coll Radiol). 2022-7

[10]
Nintedanib enhances the efficacy of PD-L1 blockade by upregulating MHC-I and PD-L1 expression in tumor cells.

Theranostics. 2022

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