BACKGROUND As immune checkpoint inhibitors(ICIs)have become widely used in lung cancer treatment,immune-related adverse events(irAEs)warrant sufficient attention.Checkpoint inhibitor-related pneumonitis(CIP)is one of ...BACKGROUND As immune checkpoint inhibitors(ICIs)have become widely used in lung cancer treatment,immune-related adverse events(irAEs)warrant sufficient attention.Checkpoint inhibitor-related pneumonitis(CIP)is one of the most concerning adverse events as it is uncommon but life threatening.CASE SUMMARY The patient whose case is reported here experienced three episodes of CIP in a span of 4 mon.Interestingly,the three episodes of CIP involved different regions of the lung separately.Taking these pneumonitis areas together makes nearly a whole lung area.CONCLUSION This case showed that recurrent CIPs may occur repeatedly until the whole lung is involved,suggesting that the follow-up period of CIP should be long enough,and the rechallenge of ICI should be done with due caution.展开更多
Immune checkpoint inhibitors(ICIs)are new and promising therapeutic agents for non-small cell lung cancer(NSCLC).However,along with demonstrating remarkable efficacy,ICIs can also trigger immune-related adverse events...Immune checkpoint inhibitors(ICIs)are new and promising therapeutic agents for non-small cell lung cancer(NSCLC).However,along with demonstrating remarkable efficacy,ICIs can also trigger immune-related adverse events.Checkpoint inhibitor pneumonitis(CIP)has been reported to have a morbidity rate of 3%to 5%and a mortality rate of 10%to 17%.Moreover,the incidence of CIP in NSCLC is higher than that in other tumor types,reaching 7%to 13%.With the increased use of ICIs in NSCLC,CIP has drawn extensive attention from oncologists and cancer researchers.Identifying high risk factors for CIP and the potential mechanism of CIP are key points in preventing and monitoring serious adverse events.In this review,the results of our analysis and summary of previous studies suggested that the risk factors for CIP may include previous lung disease,prior thoracic irradiation,and combinations with other drugs.Our review also explored potential mechanisms closely related toCIP,including increasedT cell activity against associated antigens in tumor and normal tissues,preexisting autoantibodies,and inflammatory cytokines.展开更多
Immune checkpoint inhibitors(ICIs)are widely used due to their effectiveness in treating various tumors.Immune-related adverse events(irAEs)are defined as adverse effects resulting from ICI treatment.Gastrointestinal ...Immune checkpoint inhibitors(ICIs)are widely used due to their effectiveness in treating various tumors.Immune-related adverse events(irAEs)are defined as adverse effects resulting from ICI treatment.Gastrointestinal irAEs are a common type of irAEs characterized by intestinal side effects,such as diarrhea and colitis,which may lead to the cessation of ICIs.Although irAE gastritis is rarely reported,it may lead to serious complications such as gastrorrhagia.Furthermore,irAE gastritis is often difficult to identify early due to its diverse symptoms.Although steroid hormones and immunosuppressants are commonly used to reverse irAEs,the best regimen and dosage for irAE gastritis remains uncertain.In addition,the risk of recurrence of irAE gastritis after the reuse of ICIs should be considered.In this editorial,strategies such as early identification,pathological diagnosis,mana-gement interventions,and immunotherapy rechallenge are discussed to enable clinicians to better manage irAE gastritis and improve the prognosis of these patients.展开更多
Immune checkpoint inhibitors(ICIs)are widely used due to their effectiveness in treating various tumors.Immune-related adverse events(irAEs)are defined as adverse effects resulting from ICI treatment.Gastrointestinal ...Immune checkpoint inhibitors(ICIs)are widely used due to their effectiveness in treating various tumors.Immune-related adverse events(irAEs)are defined as adverse effects resulting from ICI treatment.Gastrointestinal irAEs are a common type of irAEs characterized by intestinal side effects,such as diarrhea and colitis,which may lead to the discontinuation of ICIs.展开更多
患者女,61岁,右肺腺癌伴右肺门、纵隔、右锁骨上淋巴结转移及多发骨转移3年余,接受程序性死亡蛋白1(programmed death protein 1,PD-1)抑制剂治疗5个月后出现气短,进行性加重,无发热、咳嗽、咳痰。查体:双肺呼吸音粗,双下肺可闻及velcr...患者女,61岁,右肺腺癌伴右肺门、纵隔、右锁骨上淋巴结转移及多发骨转移3年余,接受程序性死亡蛋白1(programmed death protein 1,PD-1)抑制剂治疗5个月后出现气短,进行性加重,无发热、咳嗽、咳痰。查体:双肺呼吸音粗,双下肺可闻及velcro啰音。实验室检查:白细胞计数12.5×10^9/L,中性粒细胞73.4%。CT:双肺弥漫性分布实变影及磨玻璃影,伴支气管扩张,以双肺下叶基底段及胸膜下为著(图1A),提示双肺炎症,病因待查?行纤维支气管镜检查。病理:光镜下见局部肺泡间隔断裂,少量肺泡内纤维结节形成,肺泡上皮细胞增生、肺间质增厚及多种炎症细胞浸润,未见肿瘤细胞(图1B)。病理诊断:免疫检查点抑制剂相关肺炎(checkpoint inhibitor-related pneumonitis,CIP)。立即停止免疫治疗,予泼尼松治疗3周,复查CT显示双肺病变部分吸收,仍见多发磨玻璃影及实变影,伴支气管扩张(图1C)。予减量泼尼松连续治疗3个月,复查CT:双肺磨玻璃影、实变较前明显增多(图1D)。继续治疗1周,症状改善,患者出院并接受定期复查。展开更多
Patients with bronchogenic carcinoma comprise a high-risk group for coronavirus disease 2019(COVID-19),pneumonia and related complications.Symptoms of COVID-19 related pulmonary syndrome may be similar to deterioratin...Patients with bronchogenic carcinoma comprise a high-risk group for coronavirus disease 2019(COVID-19),pneumonia and related complications.Symptoms of COVID-19 related pulmonary syndrome may be similar to deteriorating symptoms encountered during bronchogenic carcinoma progression.These resemblances add further complexity for imaging assessment of bronchogenic carcinoma.Similarities between clinical and imaging findings can pose a major challenge to clinicians in distinguishing COVID-19 super-infection from evolving bronchogenic carcinoma,as the above-mentioned entities require very different therapeutic approaches.However,the goal of bronchogenic carcinoma management during the pandemic is to minimize the risk of exposing patients to COVID-19,whilst still managing all life-threatening events related to bronchogenic carcinoma.The current pandemic has forced all healthcare stakeholders to prioritize per value resources and reorganize therapeutic strategies for timely management of patients with COVID-19 related pulmonary syndrome.Processing of radiographic and computed tomography images by means of artificial intelligence techniques can facilitate triage of patients.Modified and newer therapeutic strategies for patients with bronchogenic carcinoma have been adopted by oncologists around the world for providing uncompromised care within the accepted standards and new guidelines.展开更多
文摘BACKGROUND As immune checkpoint inhibitors(ICIs)have become widely used in lung cancer treatment,immune-related adverse events(irAEs)warrant sufficient attention.Checkpoint inhibitor-related pneumonitis(CIP)is one of the most concerning adverse events as it is uncommon but life threatening.CASE SUMMARY The patient whose case is reported here experienced three episodes of CIP in a span of 4 mon.Interestingly,the three episodes of CIP involved different regions of the lung separately.Taking these pneumonitis areas together makes nearly a whole lung area.CONCLUSION This case showed that recurrent CIPs may occur repeatedly until the whole lung is involved,suggesting that the follow-up period of CIP should be long enough,and the rechallenge of ICI should be done with due caution.
基金This work was supported by a grant from the Wu Jieping Medical Foundation(Grant No.320675018288).
文摘Immune checkpoint inhibitors(ICIs)are new and promising therapeutic agents for non-small cell lung cancer(NSCLC).However,along with demonstrating remarkable efficacy,ICIs can also trigger immune-related adverse events.Checkpoint inhibitor pneumonitis(CIP)has been reported to have a morbidity rate of 3%to 5%and a mortality rate of 10%to 17%.Moreover,the incidence of CIP in NSCLC is higher than that in other tumor types,reaching 7%to 13%.With the increased use of ICIs in NSCLC,CIP has drawn extensive attention from oncologists and cancer researchers.Identifying high risk factors for CIP and the potential mechanism of CIP are key points in preventing and monitoring serious adverse events.In this review,the results of our analysis and summary of previous studies suggested that the risk factors for CIP may include previous lung disease,prior thoracic irradiation,and combinations with other drugs.Our review also explored potential mechanisms closely related toCIP,including increasedT cell activity against associated antigens in tumor and normal tissues,preexisting autoantibodies,and inflammatory cytokines.
基金Supported by Joint Funds for the Innovation of Science and Technology,Fujian Province,China,No.2021Y9227Natural Science Foundation of Fujian Province,China,No.2023J011254+2 种基金The Science Foundation for The Excellent Youth Scholars of Fujian Provincial Health Commission,China,No.2022ZQNZD009The Special Research Funds for Local Science and Technology Development Guided by Central Government,Fujian Province,China,No.2023L3020Fujian Medical University Student Innovation and Entrepreneurship Training Project,China,No.JC2023191.
文摘Immune checkpoint inhibitors(ICIs)are widely used due to their effectiveness in treating various tumors.Immune-related adverse events(irAEs)are defined as adverse effects resulting from ICI treatment.Gastrointestinal irAEs are a common type of irAEs characterized by intestinal side effects,such as diarrhea and colitis,which may lead to the cessation of ICIs.Although irAE gastritis is rarely reported,it may lead to serious complications such as gastrorrhagia.Furthermore,irAE gastritis is often difficult to identify early due to its diverse symptoms.Although steroid hormones and immunosuppressants are commonly used to reverse irAEs,the best regimen and dosage for irAE gastritis remains uncertain.In addition,the risk of recurrence of irAE gastritis after the reuse of ICIs should be considered.In this editorial,strategies such as early identification,pathological diagnosis,mana-gement interventions,and immunotherapy rechallenge are discussed to enable clinicians to better manage irAE gastritis and improve the prognosis of these patients.
基金Supported by the National Natural Science Foundation of China,No.81671226Natural Science Foundation of Henan Province,No.232300421047+1 种基金Science and Technology Innovation Talents in Universities of Henan Province,No.24HASTIT067Henan Province Young and Middle-aged Health Science and Technology Innovation Talent Project,No.JQRC2023001.
文摘Immune checkpoint inhibitors(ICIs)are widely used due to their effectiveness in treating various tumors.Immune-related adverse events(irAEs)are defined as adverse effects resulting from ICI treatment.Gastrointestinal irAEs are a common type of irAEs characterized by intestinal side effects,such as diarrhea and colitis,which may lead to the discontinuation of ICIs.
文摘患者女,61岁,右肺腺癌伴右肺门、纵隔、右锁骨上淋巴结转移及多发骨转移3年余,接受程序性死亡蛋白1(programmed death protein 1,PD-1)抑制剂治疗5个月后出现气短,进行性加重,无发热、咳嗽、咳痰。查体:双肺呼吸音粗,双下肺可闻及velcro啰音。实验室检查:白细胞计数12.5×10^9/L,中性粒细胞73.4%。CT:双肺弥漫性分布实变影及磨玻璃影,伴支气管扩张,以双肺下叶基底段及胸膜下为著(图1A),提示双肺炎症,病因待查?行纤维支气管镜检查。病理:光镜下见局部肺泡间隔断裂,少量肺泡内纤维结节形成,肺泡上皮细胞增生、肺间质增厚及多种炎症细胞浸润,未见肿瘤细胞(图1B)。病理诊断:免疫检查点抑制剂相关肺炎(checkpoint inhibitor-related pneumonitis,CIP)。立即停止免疫治疗,予泼尼松治疗3周,复查CT显示双肺病变部分吸收,仍见多发磨玻璃影及实变影,伴支气管扩张(图1C)。予减量泼尼松连续治疗3个月,复查CT:双肺磨玻璃影、实变较前明显增多(图1D)。继续治疗1周,症状改善,患者出院并接受定期复查。
文摘Patients with bronchogenic carcinoma comprise a high-risk group for coronavirus disease 2019(COVID-19),pneumonia and related complications.Symptoms of COVID-19 related pulmonary syndrome may be similar to deteriorating symptoms encountered during bronchogenic carcinoma progression.These resemblances add further complexity for imaging assessment of bronchogenic carcinoma.Similarities between clinical and imaging findings can pose a major challenge to clinicians in distinguishing COVID-19 super-infection from evolving bronchogenic carcinoma,as the above-mentioned entities require very different therapeutic approaches.However,the goal of bronchogenic carcinoma management during the pandemic is to minimize the risk of exposing patients to COVID-19,whilst still managing all life-threatening events related to bronchogenic carcinoma.The current pandemic has forced all healthcare stakeholders to prioritize per value resources and reorganize therapeutic strategies for timely management of patients with COVID-19 related pulmonary syndrome.Processing of radiographic and computed tomography images by means of artificial intelligence techniques can facilitate triage of patients.Modified and newer therapeutic strategies for patients with bronchogenic carcinoma have been adopted by oncologists around the world for providing uncompromised care within the accepted standards and new guidelines.
