中国癌症杂志2025，Vol.35Issue(3)：333-338,6.DOI:10.19401/j.cnki.1007-3639.2025.03.010
免疫检查点抑制剂治疗相关胸腔积液的研究进展
Research progress on treatment of pleural effusion related to immune checkpoint inhibitors
摘要
Abstract
Immunotherapy for cancer,as an emerging treatment modality,has made significant strides in recent years and has become a crucial therapeutic approach following surgery,radiotherapy,chemotherapy,and targeted therapy.In particular,the clinical utilization of immune checkpoint inhibitors(ICIs)has not only enhanced the survival rates of patients with refractory or recurrent tumors but has also significantly optimized the overall strategy for cancer treatment.However,as the population undergoing cancer immunotherapy continues to grow,this expansion not only yields clinical benefits but also precipitates a range of specific adverse reactions known as immune-related adverse events(irAEs).Pleural effusion is a common and severe complication in cancer patients,significantly affecting both their quality of life and treatment outcomes.Typically,tumor-related pleural effusion is often due to pleural metastasis,with malignant pleural effusion(MPE)characterized by rapid growth,being difficult to control,and tendency for recurrence.With the approval of new drugs and the expansion of indications for existing medications,the number of cancer patients receiving ICIs treatment is increasing,bringing ICIs-related pleural effusion into focus.While ICIs treatment-related pleural effusion is relatively rare in clinical practice,it is closely linked to treatment choices of patients and prognosis.Unlike MPE,the pathogenesis of ICIs treatment-related pleural effusion is more complex,not only involving non-specific immune activation leading to autoimmune inflammatory reactions but also potentially related to nodular pleural granulomatous reactions,eosinophilic chronic pleurisy,and tumor-infiltrating lymphocytes.In terms of diagnosis,ICIs treatment-related pleural effusion is typically diagnosed through exclusion,requiring the exclusion of other causes such as tumor progression,radiotherapy,and chemotherapy-induced pleural effusion,adding complexity and difficulty to the diagnostic process.Treatment for ICIs treatment-related pleural effusion often involves glucocorticoids,tocilizumab,or infliximab,aiming to alleviate symptoms and improve prognosis by suppressing excessive immune reactions.Preventing the occurrence of ICIs treatment-related pleural effusion is equally crucial,necessitating comprehensive patient assessment before ICIs administration and continuous monitoring during treatment to promptly detect and manage potential adverse reactions.Through this comprehensive management approach,the impact of ICIs treatment-related pleural effusion on patient quality of life and treatment outcomes can be minimized,optimizing overall treatment results.This review aimed to explore the pathogenesis,histological features,clinical manifestations,diagnostic methods and treatment strategies of ICIs treatment-related pleural effusion,and delve into the characteristics of ICIs treatment-related pleural effusion,in order to enhance understanding of this complication and provide a reference for clinical practice.关键词
恶性肿瘤/免疫检查点抑制剂/胸腔积液/不良反应/治疗Key words
Malignant tumor/Immune checkpoint inhibitors/Pleural effusion/Adverse events/Treatment分类
医药卫生引用本文复制引用
安天棋,田建辉,周奕阳,罗斌,阙祖俊,刘瑶,于盼,赵瑞华,杨蕴..免疫检查点抑制剂治疗相关胸腔积液的研究进展[J].中国癌症杂志,2025,35(3):333-338,6.基金项目
上海市卫生健康领军人才(2022LJ014) （2022LJ014）
上海市进一步加快中医药传承创新发展三年行动计划[ZY(2021-2023)-0211]. Leading Talent in Health and Wellness of Shanghai Municipality(2022LJ014) （2021-2023）
Three-Year Action Plan for Further Accelerating the Inheritance and Innovative Development of Traditional Chinese Medicine in Shanghai Municipality[ZY(2021-2023)-0211]. （2021-2023）
