纳武利尤单抗致免疫相关性肺炎文献分析

目的：分析纳武利尤单抗致免疫相关性肺炎发生情况、临床特点、治疗与转归以及再给药后肺炎复发情况，为临床治疗过程中免疫相关性肺炎的鉴别及处置提供参考。方法：检索Web of Science、PubMed、中国知网、维普数据库和万方数据库关于纳武利尤单抗致免疫相关性肺炎的文献并进行分析。结果：纳武利尤单抗致免疫相关性肺炎的个案报道共57例，中位发生时间为（2.6±2.3）个月，其影像学特征主要表现为GGO、实变和网格状影，肺炎类型主要表现为隐源性机化性肺炎和非特异性间质性肺炎。49例经停药和（或）对症治疗后好转或痊愈，1例出现呼吸衰竭，7例死亡。好转后，10例患者再次给予纳武利尤单抗治疗，4例复发。结论：纳武利尤单抗治疗过程中需关注患者的临床症状及肺部影像学特征，鉴别其可能导致的免疫相关性肺炎，发生免疫相关性肺炎的患者需根据其严重程度不同予以相应的治疗手段，同时应警惕再次给药后的肺炎复发风险。

Literature analysis of immune-related pneumonia induced by Nivolumab

OBJECTIVE To analyze the incidence, clinical characteristics, treatment and outcome of immune-related pneumonia caused by Navulizumab and the recurrence of pneumonia after re-administration, so as to provide reference for the differentiation and treatment of immune-related pneumonia during clinical treatment. METHODS Web of Science, PubMed, CNKI, VIP and Wanfang Database were searched for immune-related pneumonia induced by Nivolumab, and selected literatures were further analyzed statistically. RESULTS A total of 57 cases of immune-related pneumonia induced by navulizumab were identified and included. The median time of immune-related pneumonia induced by Nivolumab was (2.6±2.3) months and the typical imaging features were ground-glass opacities, consolidations and grid-like shadow. The main types of pneumonia were cryptogenic organizing pneumonia and nonspecific interstitial pneumonia.Forty-nine patients were improved or recovered after drug withdrawal and/or symptomatic treatment, in which one patient developed respiratory failure and seven patients died. After improvement, 10 patients were retreated with navulizumab and 4 relapsed. CONCLUSION The clinical symptoms and lung imaging characteristics of patients with immune-related pneumonia should be paid attention during the treatment with Navulizumab. Patients with immune-related pneumonia should be treated according to their severity, and the risk of recurrence of pneumonia after re-administration should be monitored.