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Li F, Zheng L, Xu X, Jin J, Li X, Zhou L. The impact of chronic obstructive pulmonary disease on the risk of immune-related pneumonitis in lung cancer patients undergoing immunotherapy: a systematic review and meta-analysis. BMC Pulm Med 2024; 24:393. [PMID: 39143553 PMCID: PMC11323643 DOI: 10.1186/s12890-024-03180-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 07/23/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Lung cancer, a leading cause of cancer mortality, poses significant treatment challenges. The use of immune checkpoint inhibitors (ICIs) has revolutionized therapy, but it is associated with immune-related pneumonitis (IRP). This study systematically reviews and analyzes the impact of Chronic Obstructive Pulmonary Disease (COPD) on the risk of IRP in lung cancer patients undergoing immunotherapy. METHODS Adhering to PRISMA guidelines and using the PICO framework, a comprehensive search across PubMed, Embase, Web of Science, and the Cochrane Library was conducted. Inclusion criteria encompassed peer-reviewed studies involving lung cancer patients treated with ICIs, comparing those with and without COPD. The primary outcome was the incidence and risk of IRP. The Newcastle-Ottawa Scale evaluated study quality. The effect size was calculated using random or fixed-effects models based on the observed heterogeneity. We assessed the heterogeneity between studies and conducted a sensitivity analysis. RESULTS The search identified 1026 articles, with six meeting the criteria for inclusion. Studies varied in design and geography, predominantly retrospective cohort studies. Patients with COPD had an increased risk of IRP (OR = 1.54, 95% CI [1.24, 1.92, P < 0.01). Subgroup analysis based on radiation therapy exposure (< 40% and ≥ 40%) also indicated a heightened IRP risk in COPD patients. Sensitivity analysis affirmed the robustness of the results, and publication bias was not significant. CONCLUSIONS Lung cancer patients with COPD undergoing immunotherapy have a significantly increased risk of developing IRP. This highlights the necessity for vigilant monitoring and individualized treatment strategies to improve the safety and effectiveness of immunotherapy in this group.
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Affiliation(s)
- Fangyuan Li
- Department of Medical Oncology, The First People's Hospital of Linping District, No. 369, Yingbin Road, Nanyuan Street, Linping District, Hangzhou, 31110, Zhejiang Province, China
| | - Lei Zheng
- Department of Medical Oncology, The First People's Hospital of Linping District, No. 369, Yingbin Road, Nanyuan Street, Linping District, Hangzhou, 31110, Zhejiang Province, China
| | - Xiaoxia Xu
- Department of Medical Oncology, The First People's Hospital of Linping District, No. 369, Yingbin Road, Nanyuan Street, Linping District, Hangzhou, 31110, Zhejiang Province, China
| | - Jianjiang Jin
- Department of Medical Oncology, The First People's Hospital of Linping District, No. 369, Yingbin Road, Nanyuan Street, Linping District, Hangzhou, 31110, Zhejiang Province, China
| | - Xingxing Li
- Department of Medical Oncology, The First People's Hospital of Linping District, No. 369, Yingbin Road, Nanyuan Street, Linping District, Hangzhou, 31110, Zhejiang Province, China
| | - Li Zhou
- Department of Medical Oncology, The First People's Hospital of Linping District, No. 369, Yingbin Road, Nanyuan Street, Linping District, Hangzhou, 31110, Zhejiang Province, China.
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Bang Henriksen M, Hansen TF, Jensen LH, Brasen CL, Borg M, Hilberg O, Løkke A. Lung cancer among outpatients with COPD: a 7-year cohort study. ERJ Open Res 2024; 10:00064-2024. [PMID: 39040576 PMCID: PMC11261374 DOI: 10.1183/23120541.00064-2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 03/04/2024] [Indexed: 07/24/2024] Open
Abstract
Introduction Lung cancer (LC) is the most common cause of cancer-related deaths worldwide, and its prognosis upon metastasis remains poor. Patients with COPD face a significantly elevated LC risk, up to six times greater than those with normal lung function. We aimed to investigate LC prevalence and stage distribution among COPD outpatients. Furthermore, we aimed to outline the COPD-related variables associated with referral for LC examination. Methods We conducted a retrospective analysis encompassing the period from 1 January 2012 to 31 December 2018 on all outpatients with COPD and LC and individuals referred for LC examinations. Results Among all COPD outpatients, 2231 patients (18%) were referred for LC examinations and 565 (4.6%) were diagnosed with LC. LC patients with COPD were more likely to be stage I-II, in contrast to the non-COPD LC population (46% versus 26%, p<0.001 for all). Patients referred for LC examinations exhibited higher use of COPD-related medications, reported more severe dyspnoea (69% versus 66% with Medical Research Council dyspnoea score >2) and experienced a greater frequency of exacerbations (30% versus 24% with two or more exacerbations). Conclusion Our study revealed a notably high LC incidence among COPD outpatients. LC patients with COPD were diagnosed at earlier stages, and outpatients with more pronounced COPD symptoms were more inclined to undergo LC diagnostics. The overrepresentation of LC cases among COPD outpatients emphasises the importance of tailoring specific screening initiatives for this demographic.
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Affiliation(s)
- Margrethe Bang Henriksen
- Department of Oncology, Vejle University Hospital, Vejle, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Torben Frøstrup Hansen
- Department of Oncology, Vejle University Hospital, Vejle, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | | | - Claus Lohman Brasen
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Department of Biochemistry and Immunology, Vejle University Hospital, Vejle, Denmark
| | - Morten Borg
- Department of Internal Medicine, Vejle University Hospital, Vejle, Denmark
| | - Ole Hilberg
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Department of Internal Medicine, Vejle University Hospital, Vejle, Denmark
| | - Anders Løkke
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Department of Internal Medicine, Vejle University Hospital, Vejle, Denmark
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Mao X, Wu S, Huang D, Li C. Complications and comorbidities associated with antineoplastic chemotherapy: Rethinking drug design and delivery for anticancer therapy. Acta Pharm Sin B 2024; 14:2901-2926. [PMID: 39027258 PMCID: PMC11252465 DOI: 10.1016/j.apsb.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 01/29/2024] [Accepted: 02/10/2024] [Indexed: 07/20/2024] Open
Abstract
Despite the considerable advancements in chemotherapy as a cornerstone modality in cancer treatment, the prevalence of complications and pre-existing diseases is on the rise among cancer patients along with prolonged survival and aging population. The relationships between these disorders and cancer are intricate, bearing significant influence on the survival and quality of life of individuals with cancer and presenting challenges for the prognosis and outcomes of malignancies. Herein, we review the prevailing complications and comorbidities that often accompany chemotherapy and summarize the lessons to learn from inadequate research and management of this scenario, with an emphasis on possible strategies for reducing potential complications and alleviating comorbidities, as well as an overview of current preclinical cancer models and practical advice for establishing bio-faithful preclinical models in such complex context.
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Affiliation(s)
- Xiaoman Mao
- College of Pharmaceutical Sciences, Southwest University, Chongqing 400715, China
| | - Shuang Wu
- Medical Research Institute, Southwest University, Chongqing 400715, China
| | - Dandan Huang
- College of Pharmaceutical Sciences, Southwest University, Chongqing 400715, China
| | - Chong Li
- College of Pharmaceutical Sciences, Southwest University, Chongqing 400715, China
- Medical Research Institute, Southwest University, Chongqing 400715, China
- School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China
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Gémes N, Balog JÁ, Neuperger P, Schlegl E, Barta I, Fillinger J, Antus B, Zvara Á, Hegedűs Z, Czimmerer Z, Manczinger M, Balogh GM, Tóvári J, Puskás LG, Szebeni GJ. Single-cell immunophenotyping revealed the association of CD4+ central and CD4+ effector memory T cells linking exacerbating chronic obstructive pulmonary disease and NSCLC. Front Immunol 2023; 14:1297577. [PMID: 38187374 PMCID: PMC10770259 DOI: 10.3389/fimmu.2023.1297577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/27/2023] [Indexed: 01/09/2024] Open
Abstract
Introduction Tobacco smoking generates airway inflammation in chronic obstructive pulmonary disease (COPD), and its involvement in the development of lung cancer is still among the leading causes of early death. Therefore, we aimed to have a better understanding of the disbalance in immunoregulation in chronic inflammatory conditions in smoker subjects with stable COPD (stCOPD), exacerbating COPD (exCOPD), or non-small cell lung cancer (NSCLC). Methods Smoker controls without chronic illness were recruited as controls. Through extensive mapping of single cells, surface receptor quantification was achieved by single-cell mass cytometry (CyTOF) with 29 antibodies. The CyTOF characterized 14 main immune subsets such as CD4+, CD8+, CD4+/CD8+, CD4-/CD8-, and γ/δ T cells and other subsets such as CD4+ or CD8+ NKT cells, NK cells, B cells, plasmablasts, monocytes, CD11cdim, mDCs, and pDCs. The CD4+ central memory (CM) T cells (CD4+/CD45RA-/CD45RO+/CD197+) and CD4+ effector memory (EM) T cells (CD4+/CD45RA-/CD45RO+/CD197-) were FACS-sorted for RNA-Seq analysis. Plasma samples were assayed by Luminex MAGPIX® for the quantitative measurement of 17 soluble immuno-oncology mediators (BTLA, CD28, CD80, CD27, CD40, CD86, CTLA-4, GITR, GITRL, HVEM, ICOS, LAG-3, PD-1, PD-L1, PD-L2, TIM-3, TLR-2) in the four studied groups. Results Our focus was on T-cell-dependent differences in COPD and NSCLC, where peripheral CD4+ central memory and CD4+ effector memory cells showed a significant reduction in exCOPD and CD4+ CM showed elevation in NSCLC. The transcriptome analysis delineated a perfect correlation of differentially expressed genes between exacerbating COPD and NSCLC-derived peripheral CD4+ CM or CD4+ EM cells. The measurement of 17 immuno-oncology soluble mediators revealed a disease-associated phenotype in the peripheral blood of stCOPD, exCOPD, and NSCLC patients. Discussion The applied single-cell mass cytometry, the whole transcriptome profiling of peripheral CD4+ memory cells, and the quantification of 17 plasma mediators provided complex data that may contribute to the understanding of the disbalance in immune homeostasis generated or sustained by tobacco smoking in COPD and NSCLC.
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Affiliation(s)
- Nikolett Gémes
- Laboratory of Functional Genomics, HUN-REN Biological Research Centre, Szeged, Hungary
- PhD School in Biology, University of Szeged, Szeged, Hungary
| | - József Á. Balog
- Laboratory of Functional Genomics, HUN-REN Biological Research Centre, Szeged, Hungary
| | - Patrícia Neuperger
- Laboratory of Functional Genomics, HUN-REN Biological Research Centre, Szeged, Hungary
- PhD School in Biology, University of Szeged, Szeged, Hungary
| | | | - Imre Barta
- National Korányi Institute of Pulmonology, Budapest, Hungary
| | - János Fillinger
- National Korányi Institute of Pulmonology, Budapest, Hungary
| | - Balázs Antus
- National Korányi Institute of Pulmonology, Budapest, Hungary
| | - Ágnes Zvara
- Laboratory of Functional Genomics, HUN-REN Biological Research Centre, Szeged, Hungary
| | - Zoltán Hegedűs
- Laboratory of Bioinformatics, HUN-REN Biological Research Centre, Szeged, Hungary
- Department of Biochemistry and Medical Chemistry, Medical School, University of Pécs, Pécs, Hungary
| | - Zsolt Czimmerer
- Macrophage Polarization Group, Institute of Genetics, HUN-REN Biological Research Centre, Szeged, Hungary
| | - Máté Manczinger
- Synthetic and Systems Biology Unit, Institute of Biochemistry, HUN-REN Biological Research Centre, Szeged, Hungary
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | - Gergő Mihály Balogh
- Synthetic and Systems Biology Unit, Institute of Biochemistry, HUN-REN Biological Research Centre, Szeged, Hungary
- Department of Dermatology and Allergology, University of Szeged, Szeged, Hungary
| | | | - László G. Puskás
- Laboratory of Functional Genomics, HUN-REN Biological Research Centre, Szeged, Hungary
- Avicor Ltd., Szeged, Hungary
- Avidin Ltd., Szeged, Hungary
| | - Gábor J. Szebeni
- Laboratory of Functional Genomics, HUN-REN Biological Research Centre, Szeged, Hungary
- Department of Physiology, Anatomy and Neuroscience, Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
- CS-Smartlab Devices Ltd., Kozármisleny, Hungary
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O’Shaughnessy M, Sheils O, Baird AM. The Lung Microbiome in COPD and Lung Cancer: Exploring the Potential of Metal-Based Drugs. Int J Mol Sci 2023; 24:12296. [PMID: 37569672 PMCID: PMC10419288 DOI: 10.3390/ijms241512296] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/28/2023] [Accepted: 07/29/2023] [Indexed: 08/13/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) and lung cancer 17 are two of the most prevalent and debilitating respiratory diseases worldwide, both associated with high morbidity and mortality rates. As major global health concerns, they impose a substantial burden on patients, healthcare systems, and society at large. Despite their distinct aetiologies, lung cancer and COPD share common risk factors, clinical features, and pathological pathways, which have spurred increasing research interest in their co-occurrence. One area of particular interest is the role of the lung microbiome in the development and progression of these diseases, including the transition from COPD to lung cancer. Exploring novel therapeutic strategies, such as metal-based drugs, offers a potential avenue for targeting the microbiome in these diseases to improve patient outcomes. This review aims to provide an overview of the current understanding of the lung microbiome, with a particular emphasis on COPD and lung cancer, and to discuss the potential of metal-based drugs as a therapeutic strategy for these conditions, specifically concerning targeting the microbiome.
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Affiliation(s)
- Megan O’Shaughnessy
- School of Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, D08 W9RT Dublin, Ireland
| | - Orla Sheils
- School of Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, D08 W9RT Dublin, Ireland
- Department of Histopathology and Morbid Anatomy, Trinity Translational Medicine Institute, St. James’s Hospital, D08 RX0X Dublin, Ireland
| | - Anne-Marie Baird
- School of Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, D08 W9RT Dublin, Ireland
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Hosseini-Berneti SH, Karami M, Bayani F, Moghaddasi M, Babazade O, Ebrahimi P, Nikbakht HA. The study of trends in mortality of respiratory system cancers in Babol, North of Iran (2013-2021). Multidiscip Respir Med 2023; 18:929. [PMID: 38322129 PMCID: PMC10772856 DOI: 10.4081/mrm.2023.929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/28/2023] [Indexed: 02/08/2024] Open
Abstract
Background In Iran, cancers are known as the second leading cause of death, among which respiratory system cancers are particularly important because lung cancer is the second most common cause of death in this country. This study aimed to estimate the crude and age-standardized mortality and its trends during 9 years in the Northern city of Iran, Babol. Methods In this cross-sectional study, all the recorded deaths due to respiratory system cancers in Babol during the years 2013-2021 on the Classification of Causes of Deaths and Death Registration System of Babol University of Medical Sciences were taken into consideration, and the population estimate was based on the latest census. Finally, the crude and age-standardized rates of mortality and trends of cancer incidents were calculated. Results In general, 393 deaths with an overall mean age of 67.8±3.9 years have happened due to respiratory system cancers. The crude and standardized rates of respiratory system cancers increased from 6.5 and 5.5 per hundred thousand people in 2013 to 9.1 and 7.8 per hundred thousand people in 2021, respectively. With each decade in age, their trends increased significantly in men (p=0.024) and remained constant in women (p=0.262). In examining the trend of respiratory system cancers, we found an increasing trend for lung cancer and a constant trend for larynx and oropharynx cancers. There was also a decreasing trend for hypopharyngeal cancer. Conclusions The age-standardized rate and trend of respiratory system cancers are increasing. Therefore, it is important to prevent their prevalence by reducing the risk factors and increasing the general awareness of risks and timely diagnosis.
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Affiliation(s)
| | - Mohsen Karami
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Department of Parasitology and Mycology, Babol University of Medical Sciences, Babol
| | - Fatemeh Bayani
- Department of Health, Health Systems Research, Health Research Institute, Babol University of Medical Sciences, Babol
| | - Mehdi Moghaddasi
- Department of Health, Health Systems Research, Health Research Institute, Babol University of Medical Sciences, Babol
| | - Ozra Babazade
- Department of Health, Health Systems Research, Health Research Institute, Babol University of Medical Sciences, Babol
| | - Pouyan Ebrahimi
- Student Research Committee, Babol University of Medical Science, Babol
| | - Hossein-Ali Nikbakht
- Social Determinants of Health Research Center, Health Research Institute, Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
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