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Anti-PD-1/PD-L1 and anti-CTLA-4 associated checkpoint inhibitor pneumonitis in non-small cell lung cancer: Occurrence, pathogenesis and risk factors (Review)

Immune checkpoint inhibitors (ICIs) play a significant anti-tumor role in the management of non-small cell lung cancer. The most broadly used ICIs are anti-programmed death 1 (PD-1), anti-programmed cell death-ligand 1, and anti-cytotoxic T lymphocyte-associated antigen-4 monoclonal antibody. Compar...

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Autores principales: Hu, Xiao, Ren, Jin, Xue, Qianfei, Luan, Rumei, Ding, Dongyan, Tan, Jie, Su, Xin, Yang, Junling
Formato: Online Artículo Texto
Lenguaje:English
Publicado: D.A. Spandidos 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10552702/
https://www.ncbi.nlm.nih.gov/pubmed/37681488
http://dx.doi.org/10.3892/ijo.2023.5570
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author Hu, Xiao
Ren, Jin
Xue, Qianfei
Luan, Rumei
Ding, Dongyan
Tan, Jie
Su, Xin
Yang, Junling
author_facet Hu, Xiao
Ren, Jin
Xue, Qianfei
Luan, Rumei
Ding, Dongyan
Tan, Jie
Su, Xin
Yang, Junling
author_sort Hu, Xiao
collection PubMed
description Immune checkpoint inhibitors (ICIs) play a significant anti-tumor role in the management of non-small cell lung cancer. The most broadly used ICIs are anti-programmed death 1 (PD-1), anti-programmed cell death-ligand 1, and anti-cytotoxic T lymphocyte-associated antigen-4 monoclonal antibody. Compared with traditional chemotherapy, ICIs have the advantages of greater efficiency and more specific targeting. However, the resulting immune-related adverse events limit the clinical application of ICIs, especially checkpoint inhibitor pneumonitis (CIP). CIP chiefly occurs within 6 months of administration of ICIs. Excessive activation and amplification of cytotoxic T lymphocytes, helper T cells, downregulation of regulatory T cells, and over-secretion of pro-inflammatory cytokines are the dominant mechanisms underlying the pathophysiology of CIP. The dysregulation of innate immune cells, such as an increase in inflammatory monocytes, dendritic cells, neutrophils and M1 polarization of macrophages, an increase in IL-10 and IL-35, and a decrease in eosinophils, may underlie CIP. Although contested, several factors may accelerate CIP, such as a history of previous respiratory disease, radiotherapy, chemotherapy, administration of epidermal growth factor receptor tyrosine kinase inhibitors, PD-1 blockers, first-line application of ICIs, and combined immunotherapy. Interestingly, first-line ICIs plus chemotherapy may reduce CIP. Steroid hormones remain the primary treatment strategy against grade ≥2 CIP, although cytokine blockers are promising therapeutic agents. Herein, the current research on CIP occurrence, clinical and radiological characteristics, pathogenesis, risk factors, and management is summarized to further expand our understanding, clarify the prognosis, and guide treatment.
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spelling pubmed-105527022023-10-06 Anti-PD-1/PD-L1 and anti-CTLA-4 associated checkpoint inhibitor pneumonitis in non-small cell lung cancer: Occurrence, pathogenesis and risk factors (Review) Hu, Xiao Ren, Jin Xue, Qianfei Luan, Rumei Ding, Dongyan Tan, Jie Su, Xin Yang, Junling Int J Oncol Review Immune checkpoint inhibitors (ICIs) play a significant anti-tumor role in the management of non-small cell lung cancer. The most broadly used ICIs are anti-programmed death 1 (PD-1), anti-programmed cell death-ligand 1, and anti-cytotoxic T lymphocyte-associated antigen-4 monoclonal antibody. Compared with traditional chemotherapy, ICIs have the advantages of greater efficiency and more specific targeting. However, the resulting immune-related adverse events limit the clinical application of ICIs, especially checkpoint inhibitor pneumonitis (CIP). CIP chiefly occurs within 6 months of administration of ICIs. Excessive activation and amplification of cytotoxic T lymphocytes, helper T cells, downregulation of regulatory T cells, and over-secretion of pro-inflammatory cytokines are the dominant mechanisms underlying the pathophysiology of CIP. The dysregulation of innate immune cells, such as an increase in inflammatory monocytes, dendritic cells, neutrophils and M1 polarization of macrophages, an increase in IL-10 and IL-35, and a decrease in eosinophils, may underlie CIP. Although contested, several factors may accelerate CIP, such as a history of previous respiratory disease, radiotherapy, chemotherapy, administration of epidermal growth factor receptor tyrosine kinase inhibitors, PD-1 blockers, first-line application of ICIs, and combined immunotherapy. Interestingly, first-line ICIs plus chemotherapy may reduce CIP. Steroid hormones remain the primary treatment strategy against grade ≥2 CIP, although cytokine blockers are promising therapeutic agents. Herein, the current research on CIP occurrence, clinical and radiological characteristics, pathogenesis, risk factors, and management is summarized to further expand our understanding, clarify the prognosis, and guide treatment. D.A. Spandidos 2023-09-06 /pmc/articles/PMC10552702/ /pubmed/37681488 http://dx.doi.org/10.3892/ijo.2023.5570 Text en Copyright: © Hu et al. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (https://creativecommons.org/licenses/by-nc-nd/4.0/) , which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
spellingShingle Review
Hu, Xiao
Ren, Jin
Xue, Qianfei
Luan, Rumei
Ding, Dongyan
Tan, Jie
Su, Xin
Yang, Junling
Anti-PD-1/PD-L1 and anti-CTLA-4 associated checkpoint inhibitor pneumonitis in non-small cell lung cancer: Occurrence, pathogenesis and risk factors (Review)
title Anti-PD-1/PD-L1 and anti-CTLA-4 associated checkpoint inhibitor pneumonitis in non-small cell lung cancer: Occurrence, pathogenesis and risk factors (Review)
title_full Anti-PD-1/PD-L1 and anti-CTLA-4 associated checkpoint inhibitor pneumonitis in non-small cell lung cancer: Occurrence, pathogenesis and risk factors (Review)
title_fullStr Anti-PD-1/PD-L1 and anti-CTLA-4 associated checkpoint inhibitor pneumonitis in non-small cell lung cancer: Occurrence, pathogenesis and risk factors (Review)
title_full_unstemmed Anti-PD-1/PD-L1 and anti-CTLA-4 associated checkpoint inhibitor pneumonitis in non-small cell lung cancer: Occurrence, pathogenesis and risk factors (Review)
title_short Anti-PD-1/PD-L1 and anti-CTLA-4 associated checkpoint inhibitor pneumonitis in non-small cell lung cancer: Occurrence, pathogenesis and risk factors (Review)
title_sort anti-pd-1/pd-l1 and anti-ctla-4 associated checkpoint inhibitor pneumonitis in non-small cell lung cancer: occurrence, pathogenesis and risk factors (review)
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10552702/
https://www.ncbi.nlm.nih.gov/pubmed/37681488
http://dx.doi.org/10.3892/ijo.2023.5570
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