来自癌症免疫治疗的免疫相关肺毒性:一个系统的方法

Q4 Medicine

Clinical Pulmonary Medicine Pub Date : 2020-11-01 DOI:10.1097/CPM.0000000000000383

N. Thiruchelvam, V. Rajasurya, Sivagowri Tharmendira, Heather Torbic, M. Waldron, J. Stoller, D. Culver

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引用次数: 0

摘要

免疫检查点抑制剂(ICIs)是癌症治疗的主要进展之一。ICIs在治疗几种类型的癌症方面显示出显著的益处。目前在美国有6种ici可用，还有多个ici正在筹备中。免疫检查点信号通过下调t细胞激活导致癌细胞的免疫耐受。ICIs对肿瘤耐受和自身耐受的逆转可能驱动t细胞介导的毒性和免疫相关的不良反应(irAEs);然而，确切的机制尚不完全清楚。肺部irae是最令人担忧的高级别irae之一，可导致中断ICIs治疗，并导致与治疗相关的死亡。由于肺部irae的高发病率和死亡率以及ICI使用的指数增长，临床医生必须越来越容易地诊断和管理这些irae。

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Immune-related Pulmonary Toxicity From Cancer Immunotherapy: A Systematic Approach

Immune checkpoint inhibitors (ICIs) are one of the major advances in cancer treatment. ICIs have shown significant benefit in treating several types of cancer. Currently there are 6 ICIs available in the United States and multiple ICIs in the pipeline. Immune checkpoint signaling leads to immune tolerance of cancer cells through downregulation of T-cell activation. The reversal in tumor-tolerance and self-tolerance effected by ICIs likely drives both T-cell–mediated toxicity and immune-related adverse effects (irAEs); however, the exact mechanism remains not completely understood. Pulmonary irAEs are among the most feared high-grade irAEs leading to discontinuation of ICIs and, not uncommonly, treatment-related death. Because of the high degree of morbidity and mortality associated with pulmonary irAEs and the exponential growth of ICI use, clinicians must increasingly be facile in diagnosing and managing these irAEs.

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来源期刊

Clinical Pulmonary Medicine Medicine-Critical Care and Intensive Care Medicine

自引率

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发文量

期刊介绍： Clinical Pulmonary Medicine provides a forum for the discussion of important new knowledge in the field of pulmonary medicine that is of interest and relevance to the practitioner. This goal is achieved through mini-reviews on focused sub-specialty topics in areas covered within the journal. These areas include: Obstructive Airways Disease; Respiratory Infections; Interstitial, Inflammatory, and Occupational Diseases; Clinical Practice Management; Critical Care/Respiratory Care; Colleagues in Respiratory Medicine; and Topics in Respiratory Medicine.