固体瘤中先前存在的间歇性肺异常和免疫检查点抑制剂相关的肺炎:回顾性分析
Kohei Horiuchi1,2, Shinnosuke Ikemura1,3, Takashi Sato1,4
1Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
The oncologist
|August 17, 2023
概括
预先存在的间歇性肺异常 (ILA) 不会增加免疫检查点抑制剂 (ICI) 相关肺炎的风险. 然而,吸烟史是这种严重不良事件的重要预测因素.
科学领域:
- 在瘤学瘤学.
- 肺部病理学 肺部病理学
- 免疫学 免疫学 免疫学
背景情况:
- 与化疗相比,免疫检查点抑制剂 (ICI) 在各种癌症中提供了更好的结果.
- 与免疫相关的不良事件 (irAEs) 是与ICI相关的独特毒性.
- 与ICI相关的肺炎带来了严重的临床挑战,风险因素不明.
研究的目的:
- 调查先前存在的间歇性肺异常 (ILA) 和ICI相关肺炎的发展之间的关联.
- 为了确定ICI相关肺炎的潜在风险因素.
主要方法:
- 在2014年至2019年期间,对209名患有非小细胞肺癌,黑色素瘤,细胞癌或胃癌的患者进行了回顾性审查,这些患者接受了ICI (nivolumab, pembrolizumab, atezolizumab) 治疗.
- 收集基线特征,ICI前计算机断层扫描发现,临床结果和irAEs.
- 根据既定标准对先前存在的ILA进行分类.
主要成果:
- 11.0%的患者患上了ICI相关的肺炎.
- 吸烟史 (P = .005) 和ICI药物 (P = .044) 与肺炎有关.
- 以前存在的ILA及其特定的放射性特征与ICI相关的肺炎没有显著相关 (P = .428).
- 多变量分析确定吸烟史是唯一的独立预测因素 (P = .028).
结论:
- 预先存在的间歇性肺部异常不是ICI相关肺炎的显著风险因素.
- 吸烟史独立地与ICI相关的肺炎风险增加有关.
- 需要进一步的研究,以充分阐明ICI相关肺炎的风险因素.
相关概念视频
Radiological Investigation III: Pulmonary Angiogram and PET Scan
Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
Chronic Obstructive Pulmonary Disease III: Chronic Bronchitis Features
Chronic bronchitis is a key phenotype of chronic obstructive pulmonary disease (COPD), characterized by airway-centered inflammation and mucus overproduction. It develops from long-term exposure to harmful particles or gases, most commonly cigarette smoke, which triggers a persistent inflammatory response.Cellular and Structural ChangesInflammation initially affects the large bronchi and later the smaller airways, with infiltration by immune cells, including neutrophils, macrophages, and...


