Necrotizing soft tissue invasive aspergillosis in a cancer patient treated with immunosupressants due to checkpoint inhibitor-induced hepatitis

Malek, Alexandre; Taremi, Mahnaz; Spallone, Amy; Alvarez-Cardona, Julio J.; Kontoyiannis, Dimitrios P.

doi:10.1016/j.jinf.2019.10.022

Cited by 12 publications

(7 citation statements)

References 8 publications

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“…immunosuppression with a variety of causative pathogens including Aspergillus fumigatus, [26][27][28][29][30][31] P. jirovecii, [31][32][33][34] John Cunningham (JC) virus, CMV 31 33 36-38 and Campylobacter 39 (summarised in table 1). These reports highlight the need to have a low threshold of investigation for opportunistic infection following irAE treatment and consideration of P. jirovecii prophylaxis.…”

Section: State Of the Art Reviewmentioning

confidence: 99%

Infections due to dysregulated immunity: an emerging complication of cancer immunotherapy

Morelli

Fujita

Redelman-Sidi

et al. 2021

Thorax

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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.

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Section: State Of the Art Reviewmentioning

confidence: 99%

Infections due to dysregulated immunity: an emerging complication of cancer immunotherapy

Morelli

Fujita

Redelman-Sidi

et al. 2021

Thorax

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“…In addition, there are several case reports that have also highlighted opportunistic infections with a variety of pathogens, including Aspergillus fumigatus [ 40 , 41 , 42 , 43 , 44 , 45 ], Pneumocystis jirovecii [ 41 , 46 , 47 , 48 ], John Cunningham (JC) virus [ 49 , 50 , 51 ], CMV [ 41 , 52 , 53 ] and Campylobacter [ 54 ]. These reports highlight the need to have a threshold for investigation of opportunistic infections after treatment of immune-related adverse events and consideration of Pneumocystis jirovecii prophylaxis.…”

Section: Monoclonals Antibodiesmentioning

confidence: 99%

Infectious Complications of Targeted Therapies for Solid Cancers or Leukemias/Lymphomas

Pilmis

Kherabi

Huriez

et al. 2023

Cancers

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Background: Infections are well known complications of some targeted drugs used to treat solid organ cancer and hematological malignancies. Furthermore, Individual patient risk factors are associated with underlying pathologies, concomitant immunosuppressive treatment, prior treatment and use of anti-infective prophylaxis. Immune-related adverse events (irAEs) are frequent among patients treated with new targeted drugs. Objectives: In this narrative review, we present the current state of knowledge concerning the infectious complications occurring in patients treated with immune checkpoint inhibitors (ICIs), Bruton’s tyrosine kinase (BTK) inhibitors, phosphatidylinositol 3-kinase (PI3K) inhibitors, antiapoptotic protein BCL-2 inhibitors, Janus kinase inhibitors or CAR-T cell infusion. Sources: We searched for studies treating infectious complications of ICIs, BTK inhibitors, PI3K inhibitors, antiapoptotic protein BCL-2 inhibitors and CAR-T cell therapy. We included randomized, observational studies and case reports. Content: Immune-related adverse events (irAEs) are frequent among patients treated with new targeted drugs. Treatment of irAEs with corticosteroids and other immunosuppressive agents can lead to opportunistic infections. Bruton’s tyrosine kinase (BTK) inhibitors are associated with higher rate of infections, including invasive fungal infections. Implications: Infections, particularly fungal ones, are common in patients treated with BTK inhibitors even though most of the complications occurring among patients treated by ICIs or CART-cells infusion are associated with the treatment of side effects related to the use of these new treatments. The diagnosis of these infectious complications can be difficult and may require extensive investigations.

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“…A 62-year-old man with diabetes mellitus and metastatic renal cell carcinoma was initially treated with monoclonal Nivolumab and Ipilimumab to block PD-1 and CTLA-4, respectively [ 76 ]. Posterior to the finish of the scheme, this patient continued using rituximab for the carcinoma treatment [ 76 ].…”

Section: Infectious Diseases Associated With the Use Of Imtmentioning

confidence: 99%

Opportunistic Infections and Immune-Related Adverse Events Associated with Administering Immune Checkpoint Inhibitors: A Narrative Review

2023

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Manipulating the immune system by blocking the immune checkpoint receptors is the basis of immunotherapy, a relevant tool in current clinical oncology. The strategy of blocking the immune checkpoints (Immune Checkpoint Inhibitors, ICI) consists of using monoclonal antibodies to inhibit the interaction between ligand and inhibitory receptors from triggering a complete activation of helper and cytotoxic T cells to fight against tumour cells. Immunotherapy has benefited patients with diverse cancers such as stomach, lung, melanoma, and head and neck squamous cell carcinoma, among others. Unfortunately, a growing number of reports have indicated that the ICI treatment also can show a dark side under specific conditions; some of the adverse effects induced by ICI are immunosuppression, opportunistic infections, and organ-specific alterations. This review discusses some immunologic aspects related to these unwanted effects.

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Necrotizing soft tissue invasive aspergillosis in a cancer patient treated with immunosupressants due to checkpoint inhibitor-induced hepatitis

Cited by 12 publications

References 8 publications

Infections due to dysregulated immunity: an emerging complication of cancer immunotherapy

Infections due to dysregulated immunity: an emerging complication of cancer immunotherapy

Infectious Complications of Targeted Therapies for Solid Cancers or Leukemias/Lymphomas

Opportunistic Infections and Immune-Related Adverse Events Associated with Administering Immune Checkpoint Inhibitors: A Narrative Review

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