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Recommendation for the diagnosis and management of immune checkpoint inhibitor related infections

机译:免疫检查点抑制剂相关感染的诊断和处理建议

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摘要

Immune checkpoint inhibitors (ICIs) have been widely used in the management of malignant tumors. Programmed death 1 (PD‐1)/PD‐1 ligand (PD‐L1) inhibitors have been introduced to treat non‐small cell lung cancer (NSCLC) in recent years. Currently, PD‐1/PD‐L1 inhibitors are considered to have minor side effects and do not independently increase the risk of infection. However, they may cause immune‐related adverse events (irAEs) that require immunosuppressive therapy with corticosteroids and/or immunosuppressants, leading to opportunistic infections. Furthermore, there have been reports describing reactivation of chronic/latent infections without irAEs or having received immunosuppressants. Thus, immune checkpoint inhibitor related infections have received more attention worldwide. In this paper, we review available clinical data, describe the potential mechanism, and propose recommendations for the diagnosis and clinical management of PD‐1/PD‐L1 inhibitor‐related infections.
机译:免疫检查点抑制剂(ICIs)已广泛用于恶性肿瘤的治疗。近年来,已引入程序性死亡1(PD-1)/ PD-1配体(PD-1L)抑制剂来治疗非小细胞肺癌(NSCLC)。目前,PD-1 / PD-L1抑制剂被认为具有较小的副作用,并且不会独立增加感染的风险。但是,它们可能引起需要与皮质类固醇和/或免疫抑制剂进行免疫抑制治疗的免疫相关不良事件(irAE),导致机会性感染。此外,已有报道描述了在没有irAEs或已接受免疫抑制剂的情况下慢性/潜伏感染的再激活。因此,免疫检查点抑制剂相关的感染已在世界范围内引起更多关注。在本文中,我们回顾了可用的临床数据,描述了潜在的机制,并提出了与PD-1 / PD-L1抑制剂相关感染的诊断和临床处理的建议。

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