期刊目次

加入编委

期刊订阅

添加您的邮件地址以接收即将发行期刊数据:

Open Access Article

International Journal of Clinical Research. 2022; 6: (1) ; 147-153 ; DOI: 10.12208/j.ijcr.20220019.

Immune checkpoint inhibitor-related pneumonitis induced by PD-1 inhibitor: a case report and review of literature
PD-1抑制剂治疗致免疫检查点抑制剂相关性肺炎1例并文献复习

作者: 刘姚, 王小溶, 蒋南川, 马万里, 张建初 *

华中科技大学同济医学院附属协和医院呼吸与危重症医学科 湖北武汉

华中科技大学同济医学院附属协和医院放射科 湖北武汉

*通讯作者: 张建初,单位:华中科技大学同济医学院附属协和医院呼吸与危重症医学科 湖北武汉;

发布时间: 2022-03-06 总浏览量: 1379

摘要

免疫检查点抑制剂是癌症的新型有效治疗手段,但也带来了免疫相关不良事件,其中肺炎为在为常见的不良反应之一。我们报道一例肺鳞状细胞癌患者在使用PD-1抑制剂治疗后免出现疫检查点抑制剂相关性肺炎(CTCAE 2级)的病例,其肺CT主要表现为细支气管炎、机化性肺炎及肺肿块,肺活检病理示间质增生纤维化伴淋巴细胞浸润 ,同时我们文献回顾免疫抑制剂相关性肺炎的临床特征,影像学特征,病理学及治疗原则。

关键词: 免疫检查点抑制剂;免疫相关性不良事件;肺炎;胸部CT;病理学

Abstract

Immune checkpoint inhibitors are novel and effective treatments for cancer, but they also bring immune-related adverse events, of which pneumonia is one of the commonadversereactions. We report a case of immune checkpoint inhibitors-related pneumonitis (CTCAE 2) in a patient with lung squamous cell cancer treated with PD-1 inhibitor, in which lung computed tomography mainly showed bronchiolitis, organizing pneumonia and pulmonary mass-like lesions, and lung biopsy pathology showed interstitial fibroplasia with lymphocyte infiltration.Meanwhile, we reviewed literatures to describe the clinical features, imaging features, pathology and treatment for immune checkpoint inhibitors-related pneumonitis.

Key words: Immune Checkpoint Inhibitors; Immune-Related Adverse Events; Pneumonia; Chest CT Image; Pathology

参考文献 References

[1] Bagchi S, Yuan R, Engleman EG. Immune Checkpoint Inhibitors for the Treatment of Cancer: Clinical Impact and Mechanisms of Response and Resistance. Annu Rev Pathol. 2021;16:223-249. 

[2] Han Y, Liu D, Li L. PD-1/PD-L1 pathway: current researches in cancer. Am J Cancer Res. 2020;10(3): 727-742.

[3] Common Terminology Criteria for Adverse Events (CTCAE).National Cancer Institute. 2017. 

https://ctep.cancer.gov/protocolDevelopment/electronic_applications/docs/CTCAE_v5_Quick_Reference_5x7.pdf.Accessed Sept 14th 2019.

[4] Baxi S, Yang A, Gennarelli RL, et al. Immune-related adverse events for anti-PD-1 and anti-PD-L1 drugs: systematic review and meta-analysis. BMJ. 2018;360:k793. Published 2018 Mar 14.

[5] Suresh K, Naidoo J, Lin CT, Danoff S. Immune Checkpoint Immunotherapy for Non-Small Cell Lung Cancer: Benefits and Pulmonary Toxicities. Chest. 2018;154(6):1416-1423.

[6] Liu SY, Wu YL. Tislelizumab: an investigational anti-PD-1 antibody for the treatment of advanced non-small cell lung cancer (NSCLC). Expert Opin Investig Drugs. 2020;29(12):1355-1364.

[7] Lee A, Keam SJ. Tislelizumab: First Approval. Drugs. 2020;80(6):617-624.

[8] Gomatou G, Tzilas V, Kotteas E, Syrigos K, Bouros D. Immune Checkpoint Inhibitor-Related Pneumonitis. Respiration. 2020;99(11):932-942.

[9] Khoja L, Day D, Wei-Wu Chen T, Siu LL, Hansen AR. Tumour- and class-specific patterns of immune-related adverse events of immune checkpoint inhibitors: a systematic review. Ann Oncol. 2017;28(10):2377-2385.

[10] Kanai O, Kim YH, Demura Y, et al. Efficacy and safety of nivolumab in non-small cell lung cancer with preexisting interstitial lung disease. Thorac Cancer. 2018;9(7): 847-855.

[11] Suresh K, Naidoo J, Zhong Q, et al. The alveolar immune cell landscape is dysregulated in checkpoint inhibitor pneumonitis. J Clin Invest. 2019;129(10):4305-4315.

[12] Postow MA, Sidlow R, Hellmann MD. Immune-Related Adverse Events Associated with Immune Checkpoint Blockade. N Engl J Med. 2018;378(2):158-168.

[13] Kuhlman JE. The role of chest computed tomography in the diagnosis of drug-related reactions. J Thorac Imaging. 1991;6(1):52-61.

[14] Pozzessere C, Lazor R, Jumeau R, Peters S, Prior JO, Beigelman-Aubry C. Imaging Features of Pulmonary Immune-related Adverse Events. J Thorac Oncol. 2021;16(9):1449-1460.

[15] Nishino M, Ramaiya NH, Awad MM, et al. PD-1 Inhibitor-Related Pneumonitis in Advanced Cancer Patients: Radiographic Patterns and Clinical Course. Clin Cancer Res. 2016;22(24):6051-6060.

[16] Travis WD, Costabel U, Hansell DM, et al. An official American Thoracic Society/European Respiratory Society statement: Update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med. 2013;188(6):733-748.

[17] Kalisz KR, Ramaiya NH, Laukamp KR, Gupta A. Immune Checkpoint Inhibitor Therapy-related Pneumonitis: Patterns and Management. Radiographics. 2019;39(7): 1923-1937.

[18] Zhong L, Altan M, Shannon VR, Sheshadri A. Immune-Related Adverse Events: Pneumonitis. Adv Exp Med Biol. 2020;1244:255-269.

[19] Wang H, Guo X, Zhou J, et al. Clinical diagnosis and treatment of immune checkpoint inhibitor-associated pneumonitis. Thorac Cancer. 2020;11(1):191-197.

[20] Ando H, Suzuki K, Yanagihara T. Insights into Potential Pathogenesis and Treatment Options for Immune- Checkpoint Inhibitor-Related Pneumonitis. Biomedicines. 2021;9(10):1484. Published 2021 Oct 16.

[21] Brahmer JR, Lacchetti C, Schneider BJ, et al. Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: American Society of Clinical Oncology Clinical Practice Guideline. J Clin Oncol. 2018;36(17):1714-1768.

[22] Haanen JBAG, Carbonnel F, Robert C, et al. Management of toxicities from immunotherapy: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2018;29(Suppl 4):iv264-iv266.

[23] Colen RR, Fujii T, Bilen MA, et al. Radiomics to predict immunotherapy-induced pneumonitis: proof of concept. Invest New Drugs. 2018;36(4):601-607.

[24] Tarhini AA, Zahoor H, Lin Y, et al. Baseline circulating IL-17 predicts toxicity while TGF-β1 and IL-10 are prognostic of relapse in ipilimumab neoadjuvant therapy of melanoma. J Immunother Cancer. 2015;3:39.

引用本文

刘姚, 王小溶, 蒋南川, 马万里, 张建初, PD-1抑制剂治疗致免疫检查点抑制剂相关性肺炎1例并文献复习[J]. 国际临床研究杂志, 2022; 6: (1) : 147-153.