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-国际临床研究杂志-CSCIED科技核心评价数据库-手机版

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

Immune checkpoint inhibitor-related pneumonitis induced by PD-1 inhibitor: a case report and review of literature

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DOI	10.12208/j.ijcr.20220019
刊名	国际临床研究杂志 International Journal of Clinical Research
年，卷(期)	2022, 6(1)
作者	刘姚,王小溶,蒋南川,马万里,张建初*,
作者单位	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 ; 华中科技大学同济医学院附属协和医院放射科湖北武汉 ;
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。
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.
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
KeyWord	Immune Checkpoint Inhibitors; Immune-Related Adverse Events; Pneumonia; Chest CT Image; Pathology
基金项目
页码	147-153

参考文献
相关文献

[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.

文献评论

姚**广西中医****** 已认证✔

2026-01-21 10:39:02

本文通过详细报道1例临床真实病例并展开对PD-1抑制剂相关性肺炎的文献复习及诊断治疗的临床分享，具有一定的临床参考价值。

李**复旦大学****** 已认证✔

2025-12-10 03:43:56

作者基于 1 例 PD-1 抑制剂相关性肺炎病例，结合临床、影像及病理特点，并进行了文献复习，对 ICI 相关性肺炎的诊断要点与处理原则进行系统阐述，具有较好的临床参考意义。

陈**安庆一一****** 已认证✔

2025-10-28 11:29:11

在患者诊疗过程中，免疫相关性一直是不可忽视的部分，该文章在此方面对于临床医生有很好的指导作用和参考价值

颜**上海中医****** 已认证✔

2025-09-16 08:50:16

作者通过1例肺鳞状细胞癌患者在使用PD-1抑制剂治疗后出现肺炎，从临床资料、影像学、病理特点，结合相关文献复习，系统性讨论了疫检查点抑制剂相关性肺炎的特征及诊疗原则，对认识该类疾病有一定的临床参考价值。

王**郑州大学****** 已认证✔

2025-06-17 09:46:16

免疫相关间质性肺炎诊断一定要排除感染导致间质性肺炎，该文作者选取的病例CT影像上间质性肺炎以条索及网格为主，出现时间在应用免疫治疗3周期后，诊断前完善了气管镜检查，肺泡灌洗液送NGS排除感染导致间质性肺炎，诊疗过程规范。

h**湖南长沙******

2022-10-27 12:27:09

肺炎方面的可以了解下。

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