Research progress in immune checkpoint inhibitor associated tuberculosis infection

doi:10.3760/cma.j.cn371439-20241030-00109

Abstract

Abstract:

In recent years， programmed death-1/programmed death-ligand 1 inhibitors， as representatives of immune checkpoint inhibitors （ICIs）， have become an important advancement in the field of tumor therapy， significantly improving the survival and prognosis of tumor patients. However， immune-related adverse events associated with ICIs treatment pose challenges for clinical management. In particular， the emergence of active tuberculosis and reactivation of latent tuberculosis infection has attracted attention， and its mechanism may be closely related to the overactivation of the immune system and the changes of host-pathogen relationship. How to effectively predict and manage these adverse reactions has become a hot topic of current research.

Key words: Neoplasms, Immune checkpoint inhibitors, Tuberculosis

Liu Xunqi, An Jianghong. Research progress in immune checkpoint inhibitor associated tuberculosis infection[J]. Journal of International Oncology, 2025, 52(10): 637-640.

References 33

[1]	Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2024, 74(3): 229-263. DOI: 10.3322/caac.21834.
[2]	Li J, Zhang Y, Luo B. The programed death-1/programed death ligand-1 axis and its potential as a therapeutic target for virus-associated tumours[J]. Rev Med Virol, 2024, 34(1): e2486. DOI: 10.1002/rmv.2486.
[3]	Langan EA, Graetz V, Allerheiligen J, et al. Immune checkpoint inhibitors and tuberculosis: an old disease in a new context[J]. Lancet Oncol, 2020, 21(1): e55-e65. DOI: 10.1016/S1470-2045(19)30674-6.
[4]	喻晓雯, 张其奥, 谢建平. PD-1/PD-L1, PD-L2信号通路及其在宿主抗结核免疫中作用的研究进展[J]. 中华结核和呼吸杂志, 2024, 47(5): 485-489. DOI: 10.3760/cma.j.cn112147-20230904-00133.
[5]	Yang C, Dai F, Pulati R, et al. Clinical significance of negative costimulatory molecule PD-1/PD-L1 on peripheral blood regulatory T cell levels among patients with pulmonary tuberculosis[J]. J Trop Med, 2022, 2022: 7526501. DOI: 10.1155/2022/7526501.
[6]	Mwebaza I, Shaw R, Li Q, et al. Impact of Mycobacterium tuberculosis glycolipids on the CD4⁺ T cell-macrophage immunological synapse[J]. J Immunol, 2023, 211(9): 1385-1396. DOI: 10.4049/jimmunol.2300107. pmid: 37695687
[7]	雷艳, 张革红. 生物标志物在晚期非小细胞肺癌免疫治疗中的预测价值[J]. 国际肿瘤学杂志, 2022, 49(12): 739-744. DOI: 10.3760/cma.j.cn371439-20220816-00145.
[8]	Byeon S, Cho JH, Jung HA, et al. PD-1 inhibitors for non-small cell lung cancer patients with special issues: real-world evidence[J]. Cancer Med, 2020, 9(7): 2352-2362. DOI: 10.1002/cam4.2868.
[9]	Im Y, Lee J, Kim SJ, et al. Development of tuberculosis in cancer patients receiving immune checkpoint inhibitors[J]. Respir Med, 2020, 161: 105853. DOI: 10.1016/j.rmed.2019.105853.
[10]	Stroh GR, Peikert T, Escalante P. Active and latent tuberculosis infections in patients treated with immune checkpoint inhibitors in a non-endemic tuberculosis area[J]. Cancer Immunol Immunother, 2021, 70(11): 3105-3111. DOI: 10.1007/s00262-021-02905-8. pmid: 33770211
[11]	Bae S, Kim YJ, Kim MJ, et al. Risk of tuberculosis in patients with cancer treated with immune checkpoint inhibitors: a nationwide observational study[J]. J Immunother Cancer, 2021, 9(9): e002960. DOI: 10.1136/jitc-2021-002960.
[12]	Picchi H, Mateus C, Chouaid C, et al. Infectious complications associated with the use of immune checkpoint inhibitors in oncology: reactivation of tuberculosis after anti PD-1 treatment[J]. Clin Microbiol Infect, 2018, 24(3): 216-218. DOI: 10.1016/j.cmi.2017.12.003.
[13]	Kauffman KD, Sakai S, Lora NE, et al. PD-1 blockade exacerbates Mycobacterium tuberculosis infection in rhesus macaques[J]. Sci Immunol, 2021, 6(55): eabf3861. DOI: 10.1126/sciimmunol.abf3861.
[14]	Goletti D, Meintjes G, Andrade BB, et al. Insights from the 2024 WHO global tuberculosis report—more comprehensive action, innovation, and investments required for achieving WHO end TB goals[J]. Int J Infect Dis, 2024, 150: 107325. doi: 10.1016/j.ijid.2024.107325
[15]	Kim HW, Kim JS, Lee SH. Incidence of tuberculosis in advanced lung cancer patients treated with immune checkpoint inhibitors—a nationwide population-based cohort study[J]. Lung Cancer, 2021, 158: 107-114. DOI: 10.1016/j.lungcan.2021.05.034.
[16]	Liu K, Wang D, Yao C, et al. Increased tuberculosis incidence due to immunotherapy based on PD-1 and PD-L1 blockade: a systematic review and meta-analysis[J]. Front Immunol, 2022, 13: 727220. DOI: 10.3389/fimmu.2022.727220.
[17]	Chen HW, Kuo YW, Chen CY, et al. Increased tuberculosis reactivation risk in patients receiving immune checkpoint inhibitor-based therapy[J]. Oncologist, 2024, 29(4): e498-e506. DOI: 10.1093/oncolo/oyad340.
[18]	Zaemes J, Kim C. Immune checkpoint inhibitor use and tuberculosis: a systematic review of the literature[J]. Eur J Cancer, 2020, 132: 168-175. DOI: 10.1016/j.ejca.2020.03.015. pmid: 32375103
[19]	Anand K, Sahu G, Burns E, et al. Mycobacterial infections due to PD-1 and PD-L1 checkpoint inhibitors[J]. ESMO Open, 2020, 5(4): e000866. DOI: 10.1136/esmoopen-2020-000866.
[20]	Chan GH, Gwee YX, Low JL, et al. Immune checkpoint inhibition for non-small cell lung cancer in patients with pulmonary tuberculosis or hepatitis B: experience from a single Asian centre[J]. Lung Cancer, 2020(146): 145-153. DOI: 10.1016/j.lungcan.2020.05.020.
[21]	Fujita K, Elkington P, Redelman-Sidi G, et al. Serial interferon-gamma release assay in lung cancer patients receiving immune checkpoint inhibitors: a prospective cohort study[J]. Cancer Immunol Immunother, 2022, 71(11): 2757-2764. DOI: 10.1007/s00262-022-03198-1. pmid: 35429244
[22]	中华医学会呼吸病学分会, 国家呼吸医学中心. 综合医疗机构结核病发病高危人群的预防性治疗专家共识[J]. 中华结核和呼吸杂志, 2024, 47(10): 933-945. DOI: 10.3760/cma.j.cn112147-20240328-00173.
[23]	Anastasopoulou A, Ziogas DC, Samarkos M, et al. Reactivation of tuberculosis in cancer patients following administration of immune checkpoint inhibitors: current evidence and clinical practice recommendations[J]. J Immunother Cancer, 2019, 7(1): 239. DOI: 10.1186/s40425-019-0717-7.
[24]	Haddad FG, Kattan C, Kattan J. Should immune checkpoint inhibitors be contraindicated in lung cancer patients with latent tuberculosis?[J]. Immunotherapy, 2020, 12(11): 759-762. DOI: 10.2217/imt-2020-0069. pmid: 32517560
[25]	Chen H, Nakagawa A, Takamori M, et al. Diagnostic accuracy of the interferon-gamma release assay in acquired immunodeficiency syndrome patients with suspected tuberculosis infection: a meta-analysis[J]. Infection, 2022, 50(3): 597-606. DOI: 10.1007/s15010-022-01789-9. pmid: 35249210
[26]	中国临床肿瘤学会免疫治疗专家委员会. 免疫检查点抑制剂特殊人群应用专家共识[J]. 临床肿瘤学杂志, 2022, 27(5): 442-454. DOI: 10.3969/j.issn.1009-0460.2022.05.009.
[27]	Hu Q, Wang S, Ma L, et al. Radiological assessment of immunotherapy effects and immune checkpoint-related pneumonitis for lung cancer[J]. J Cell Mol Med, 2024, 28(5): e17895. DOI: 10.1111/jcmm.17895.
[28]	首都医科大学附属北京胸科医院/北京市结核病胸部肿瘤研究所, 中国防痨协会, 《中国防痨杂志》编辑委员会, 等. 耐药肺结核全口服化学治疗方案中国专家共识(2021年版)[J]. 中国防痨杂志, 2021, 43(9): 859-866. DOI: 10.3969/j.issn.1000-6621.2021.09.002.
[29]	He Y, Peng D, Liang P, et al. Immune checkpoint inhibitors and tuberculosis infection in lung cancer: a case series and systematic review with pooled analysis[J]. J Clin Pharmacol, 2023, 63(4): 397-409. DOI: 10.1002/jcph.2170.
[30]	Suliman AM, Bek SA, Elkhatim MS, et al. Tuberculosis following programmed cell death receptor-1 (PD-1) inhibitor in a patient with non-small cell lung cancer. Case report and literature review[J]. Cancer Immunol Immunother, 2021, 70(4): 935-944. DOI: 10.1007/s00262-020-02726-1. pmid: 33070259
[31]	Su S, Ye MF, Cai XT, et al. Assessment of anti-PD-(L)1 for patients with coexisting malignant tumor and tuberculosis classified by active, latent, and obsolete stage[J]. BMC Med, 2021, 19(1): 322. DOI: 10.1186/s12916-021-02194-z.
[32]	Lau KS, Cheung BM, Lam KO, et al. Tuberculosis reactivation at ileum following immune checkpoint inhibition with pembrolizumab for metastatic nasopharyngeal carcinoma: a case report[J]. BMC Infect Dis, 2021, 21(1): 1148. DOI: 10.1186/s12879-021-06845-7.
[33]	Lin C, Xu G, Gao S, et al. Tuberculosis infection following immune checkpoint inhibitor treatment for advanced cancer: a case report and literature review[J]. Front Immunol, 2023, 14: 1162190. DOI: 10.3389/fimmu.2023.1162190.