免疫抑制剂相关性肺炎的诊治进展

Progress in diagnosis and treatment of immune checkpoint inhibitor-associated pneumonia

免疫检查点抑制剂(ICIs)已经成为肺癌治疗的新希望,无论是晚期肺癌还是围术期治疗,ICIs都能明显改善患者的预后。然而,伴随着ICIs的广泛应用,同时还带来了器官特异性免疫相关不良事件。免疫抑制剂可能影响全身各个系统,其中免疫检查点抑制剂相关性肺炎(CIP)是指患者接受ICIs治疗后,胸部影像学出现新的浸润影,临床除外新的肺部感染或肿瘤进展等情况下,出现呼吸困难和/或其他呼吸体征/症状。目前,关于CIP发生发展的机制及临床处理策略的报道很多,本文主要就有关CIP的危险因素、发病机制、应对策略及再挑战展开综述。

Immune checkpoint inhibitors(ICIs)have become a new hope for the treatment of lung cancer.ICIs can significantly improve the prognosis of patients with advanced lung cancer or perioperative treatment.However,with the widespread use of ICIs,it also brings organ-specific immune-related adverse events(irAEs).ICIs may affect all systems of the body,among which immune checkpoint inhibitor-related pneumonia(CIP)caused by ICIs therapy refers to new infiltration in chest imaging after ICIs treatment,dyspnea and/or other respiratory signs/symptoms except for new pulmonary infection or tumor progression.At present,there are many reports about the mechanism of occurrence and development of CIP and clinical management strategies.This article mainly reviews the risk factors,pathogenesis,coping strategies,and challenges related to CIP.