Arai Makoto, Abe Mitsuhiro, Kitahara Shinsuke, Sakuma Noriko, Ohno Izumi, Takahashi Koji, Imai Chiaki, Saeki Hiromi, Suzuki Takuji, Uzawa Katsuhiro, Hanazawa Toyoyuki, Takiguchi Yuichi
Department of Medical Oncology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan.
Department of Chemotherapy, Tokyo Women's Medical University Yachiyo Medical Center, Chiba 276-8523, Japan.
Oncol Lett. 2023 May 19;26(1):288. doi: 10.3892/ol.2023.13874. eCollection 2023 Jul.
Severe drug-induced lung injury (DLI) has been reported to be associated with sequential administration of osimertinib, a third-generation tyrosine kinase inhibitor, following a programmed cell death ligand 1 (PD-L1) inhibitor. However, the relationship of sequential treatment with an anti-epidermal growth factor receptor (EGFR) antibody and PD-1 inhibitor with the risk of DLI remains to be elucidated. The present study conducted a retrospective review of the medical records of a total of 179 patients with head and neck cancer who had received treatment with cetuximab and/or a PD-1 inhibitor (nivolumab or pembrolizumab) at Chiba University Hospital (Chiba, Japan) between September 2014 and December 2020. The incidence of pneumonia and the clinical background characteristics of the patients were analyzed. The patients were classified into subgroups for analysis of the outcomes in this study: Patients who had received sequential, but not concurrent, cetuximab and PD-1 inhibitor treatment (Group C+P; n=43); patients who had received cetuximab-containing chemotherapy, but not a PD-1 inhibitor (Group C; n=101); and patients who had received PD-1 inhibitor-containing chemotherapy, but not cetuximab (Group P; n=35). The rates of DLI in the three groups were: Group C+P, 18.6%; Group C, 7.9%; and Group P, 11.4%. Prior use of ICI was not associated with any increase in the risk of DLI. DLI is seen frequently in patients receiving sequential PD-1 inhibitor and anti-EGFR antibody therapy.
据报道，在程序性细胞死亡配体1（PD-L1）抑制剂之后序贯使用第三代酪氨酸激酶抑制剂奥希替尼会导致严重的药物性肺损伤（DLI）。然而，抗表皮生长因子受体（EGFR）抗体与PD-1抑制剂序贯治疗与DLI风险之间的关系仍有待阐明。本研究对2014年9月至2020年12月期间在日本千叶大学医院接受西妥昔单抗和/或PD-1抑制剂（纳武利尤单抗或帕博利尤单抗）治疗的179例头颈癌患者的病历进行了回顾性分析。分析了患者的肺炎发病率及临床背景特征。在本研究中，将患者分为亚组以分析结果：接受西妥昔单抗和PD-1抑制剂序贯治疗但不同时使用的患者（C+P组；n = 43）；接受含西妥昔单抗化疗但未使用PD-1抑制剂的患者（C组；n = 101）；以及接受含PD-1抑制剂化疗但未使用西妥昔单抗的患者（P组；n = 35）。三组的DLI发生率分别为：C+P组18.6%；C组7.9%；P组11.4%。既往使用免疫检查点抑制剂（ICI）与DLI风险增加无关。在接受序贯PD-1抑制剂和抗EGFR抗体治疗的患者中经常出现DLI。
