RT Journal Article
SR Electronic
T1 Infections due to dysregulated immunity: an emerging complication of cancer immunotherapy
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP thoraxjnl-2021-217260
DO 10.1136/thoraxjnl-2021-217260
A1 Tommaso Morelli
A1 Kohei Fujita
A1 Gil Redelman-Sidi
A1 Paul T Elkington
YR 2021
UL http://thorax.bmj.com/content/early/2021/10/03/thoraxjnl-2021-217260.abstract
AB Immune checkpoint inhibitors (ICIs) have revolutionised cancer treatment. However, immune-related adverse events (irAEs) are a common side effect which can mimic infection. Additionally, treatment of irAEs with corticosteroids and other immunosuppressant agents can lead to opportunistic infection, which we have classed as immunotherapy infections due to immunosuppression. However, emerging reports demonstrate that some infections can be precipitated by ICIs in the absence of immunosuppressive treatment, in contrast to the majority of reported cases. These infections are characterised by a dysregulated inflammatory immune response, and so we propose they are described as immunotherapy infections due to dysregulated immunity. This review summarises the rapidly emerging evidence of these phenomena and proposes a new framework for considering infection in the context of cancer immunotherapy.