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免疫检查点抑制剂相关性肺炎:预测和管理方面的研究进展。

Immune checkpoint inhibitor-related pneumonitis: research advances in prediction and management.

机构信息

Department of Oncology, The Second Hospital of Dalian Medical University, Dalian, China.

出版信息

Front Immunol. 2024 Feb 15;15:1266850. doi: 10.3389/fimmu.2024.1266850. eCollection 2024.

Abstract

The advent of immune-checkpoint inhibitors (ICIs) has revolutionized the treatment of malignant solid tumors in the last decade, producing lasting benefits in a subset of patients. However, unattended excessive immune responses may lead to immune-related adverse events (irAEs). IrAEs can manifest in different organs within the body, with pulmonary toxicity commonly referred to as immune checkpoint inhibitor-related pneumonitis (CIP). The CIP incidence remains high and is anticipated to rise further as the therapeutic indications for ICIs expand to encompass a wider range of malignancies. The diagnosis and treatment of CIP is difficult due to the large individual differences in its pathogenesis and severity, and severe CIP often leads to a poor prognosis for patients. This review summarizes the current state of clinical research on the incidence, risk factors, predictive biomarkers, diagnosis, and treatment for CIP, and we address future directions for the prevention and accurate prediction of CIP.

摘要

免疫检查点抑制剂 (ICIs) 的出现彻底改变了过去十年间恶性实体肿瘤的治疗方式,为部分患者带来了持久的获益。然而,未得到控制的过度免疫反应可能导致免疫相关不良事件(irAEs)。irAEs 可在体内不同器官中表现出来,肺部毒性通常被称为免疫检查点抑制剂相关肺炎(CIP)。随着 ICI 的治疗适应证扩展至更广泛的恶性肿瘤范围,CIP 的发病率仍然较高,预计还会进一步上升。由于其发病机制和严重程度存在较大的个体差异,CIP 的诊断和治疗较为困难,而严重的 CIP 常导致患者预后较差。本综述总结了 CIP 的发生率、危险因素、预测生物标志物、诊断和治疗的临床研究现状,并探讨了 CIP 预防和准确预测的未来方向。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2891/10902117/2219b13f0e65/fimmu-15-1266850-g001.jpg

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