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Nontuberculous mycobacterial infections during cancer therapy with immune checkpoint inhibitors: a systematic review

Andrea Lombardi1,2, Andrea Gramegna2,3, Margherita Ori3

  • 1Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

ERJ Open Research
|December 1, 2022
PubMed

Insights

Immune checkpoint inhibitors (ICIs) may increase the risk of nontuberculous mycobacteria (NTM) infections, particularly Mycobacterium avium complex affecting the lungs. These NTM infections occurred about a year after starting ICI therapy.

Area of Science:

  • Oncology
  • Infectious Diseases
  • Immunology

Background:

  • Immune checkpoint inhibitors (ICIs) are increasingly used for cancer treatment.
  • The association between ICIs and nontuberculous mycobacteria (NTM) infections requires further investigation.

Purpose of the Study:

  • To systematically review the literature on NTM infections in patients receiving ICIs.

Main Methods:

  • Systematic literature review of studies published between June 20, 2012, and June 20, 2022.
  • Included studies described NTM infections in patients treated with ICIs.

Main Results:

  • Seven studies involving nine patients were included.
  • NTM infections during ICI therapy were primarily caused by Mycobacterium avium complex.
  • Infections predominantly affected the lungs, occurring approximately one year after treatment initiation.
  • No association was found with immunosuppressive treatments.

Conclusions:

  • NTM infections, particularly Mycobacterium avium complex, can occur during ICI therapy.
  • Lung involvement is common, with infections typically emerging one year into treatment.
  • The findings suggest a potential link between ICIs and NTM infections, warranting further research.

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