Management of pulmonary toxicity associated with immune checkpoint inhibitors.
Management of pulmonary toxicity associated with immune checkpoint inhibitors.
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DOI：
10.1183/16000617.0012-2019
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发表时间：
2019-12-31
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影响因子：
--
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中科院分区：
文献类型：
--
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在最近批准细胞毒性T淋巴细胞相关蛋白-4和程序性细胞死亡-1抑制剂用于肺癌、黑色素瘤、肾细胞癌、霍奇金淋巴瘤、膀胱癌、头颈癌之后，免疫疗法已成为肿瘤学的标准护理。除了它们的功效之外，这些药物还产生特定的免疫相关不良事件。由于免疫检查点抑制剂的处方越来越多，免疫毒性的发生率将继续上升。对免疫相关不良事件的认识是确保诊断和管理可能的严重不良事件的关键。虽然严重的免疫相关不良事件仍然罕见，但如果没有正确预测和管理，它们可能导致停止治疗或死亡。即使肺毒性不是最常见的不良事件，它仍然是关键的，因为它可能危及生命。在此，肺毒性的主要方面进行了审查，并提出了指导方针，以管理可能的副作用。免疫相关的肺毒性可能危及生命。应鼓励早期识别和治疗，包括CT扫描和支气管镜检查。治疗主要依靠类固醇。此外，应在多学科委员会中讨论再激发。http://bit.ly/2WNYH8I
Immunotherapy has become a standard of care in oncology, following the recent approvals of cytotoxic T-lymphocyte-associated protein-4 and programmed cell death-1 inhibitors in lung cancer, melanoma, renal cell carcinoma, Hodgkin's lymphoma, bladder, head and neck cancers. Besides their efficacy, these agents also generate specific immune-related adverse events. Due to the increasing prescription of immune-checkpoint inhibitors, the incidence of immune toxicity will continue to rise. The awareness of immune-related adverse events is key to ensuring both diagnosis and management of the possible serious adverse events. Although severe immune-related adverse events remain rare, they can lead to discontinued treatment or to death if they are not forecasted and managed properly. Even if lung toxicity is not the most frequent adverse event, it remains critical as it can be life-threatening. Herein, the main aspects of pulmonary toxicity are reviewed and guidelines are also proposed in order to manage the possible side-effects. Immune-related lung toxicity can be life-threatening. Early recognition and management including CT scan and bronchoscopy should be encouraged. Treatment mainly relies on steroids. In addition, re-challenge should be discussed in multidisciplinary boards. http://bit.ly/2WNYH8I
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影响因子：
3.3
作者：
de Jong, Corine;Peters, Bas J. M.;Schramel, Franz M. N. H.
通讯作者：
Schramel, Franz M. N. H.
影响因子：
50.5
作者：
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通讯作者：
Long, G. V.
影响因子：
82.9
作者：
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通讯作者：
Bluestone, Jeffrey A.
影响因子：
28.4
作者：
Johnson, Douglas B.;Sullivan, Ryan J.;Clark, Joseph I.
通讯作者：
Clark, Joseph I.
影响因子：
50.5
作者：
Champiat, S.;Lambotte, O.;Marabelle, A.
通讯作者：
Marabelle, A.