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

Thorac Cancer. 2020 Mar;11(3):805-809. doi: 10.1111/1759-7714.13313. Epub 2020 Jan 22.

Abstract

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.

Keywords: Immune checkpoint; PD-1/PD-L1 inhibitors; immune-related adverse events; infections.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Drug-Related Side Effects and Adverse Reactions / diagnosis*
  • Drug-Related Side Effects and Adverse Reactions / etiology
  • Drug-Related Side Effects and Adverse Reactions / therapy*
  • Humans
  • Immune Checkpoint Inhibitors / adverse effects*
  • Infections / chemically induced
  • Infections / diagnosis*
  • Infections / therapy*
  • Neoplasms / drug therapy*
  • Neoplasms / pathology
  • Practice Guidelines as Topic / standards*
  • Prognosis

Substances

  • Immune Checkpoint Inhibitors