Bertaglia Valentina, Morelli Anna Maria, Solinas Cinzia, Aiello Marco Maria, Manunta Silvia, Denaro Nerina, Tampellini Marco, Scartozzi Mario, Novello Silvia
Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, 10043 Orbassano, Torino, Italy.
Medical Oncology, ASL TO3 Ospedale degli Infermi, 10098 Rivoli, Torino, Italy.
Crit Rev Oncol Hematol. 2023 Apr;184:103954. doi: 10.1016/j.critrevonc.2023.103954. Epub 2023 Mar 5.
Patients with a diagnosis of lung cancer are often vulnerable to infection, and the risk is increased by tumor-associated immunosuppression and the effects of the treatments. Historically, links between the risk of infection and cytotoxic chemotherapy due to neutropenia and respiratory syndromes are well established. The advent of tyrosine kinase inhibitors (TKIs) and immune-checkpoint inhibitors (ICIs) targeting the programmed cell death-1 (PD-1)/programmed cell death- ligand 1 (PD-L1) axis and cytotoxic T-lymphocyte antigen-4 (CTLA-4) have changed the treatment paradigm for lung cancer patients. Our understanding of the risk of infections while administrating these drugs is evolving, as are the biological mechanisms that are responsible. In this overview, we focus on the risk of infection with the use of targeted therapies and ICIs, summarizing current evidence from preclinical and clinical studies and discussing their clinical implications.
被诊断为肺癌的患者通常易受感染,且肿瘤相关的免疫抑制和治疗的影响会增加感染风险。从历史上看,由于中性粒细胞减少和呼吸综合征导致的感染风险与细胞毒性化疗之间的联系已得到充分证实。靶向程序性细胞死亡蛋白1(PD-1)/程序性细胞死亡配体1(PD-L1)轴和细胞毒性T淋巴细胞抗原4(CTLA-4)的酪氨酸激酶抑制剂(TKIs)和免疫检查点抑制剂(ICIs)的出现改变了肺癌患者的治疗模式。我们对在使用这些药物时感染风险的理解正在不断发展,其背后的生物学机制也是如此。在本综述中,我们重点关注使用靶向治疗和ICIs时的感染风险,总结临床前和临床研究的现有证据,并讨论其临床意义。