免疫检查点抑制剂（ICIs）已成为非小细胞肺癌（NSCLC）不同阶段疾病的标准治疗方法。基于 NSCLC 中分子畸变和致癌驱动因素的日益表征，预计越来越多的患者将受益于 NSCLC 的口服小靶向治疗。然而，它们的同时或连续使用与各种毒性模式的风险增加相关。如果相关出版物报告了与连续或联合使用 ICI 和小靶向疗法用于 NSCLC 治疗相关的毒性问题的数据，则相关出版物将被纳入。从数据库建立到 2023 年 6 月，对 MEDLINE、Google Scholar 和 Cochrane 图书馆进行了以下请求的搜索。这篇综述强调了序贯和伴随治疗背景下的各种毒性模式（即间质性肺疾病、肝炎、皮肤病） ICI 和小靶向治疗的管理。此类毒性似乎是“药物效应”而不是“类别效应”，并且其中一些毒性对于小型靶向治疗更具特异性。这篇综述强调了治疗顺序给药的影响，并强调医生要特别小心是否在最后一次 ICI 注射后一到三个月内进行小靶向治疗。医生必须意识到同时或顺序 ICI 的严重毒性/非小细胞肺癌的小靶向治疗。需要进一步的研究来更好地了解这些毒性的机制，以便预防它们并完善 ICI 和小靶向治疗测序策略。版权所有 © 2024 作者。由爱思唯尔有限公司出版。保留所有权利。

Immune checkpoint inhibitors (ICIs) have become standard-of-care at different stage disease in non-small cell lung cancer (NSCLC). Based on the increasing characterization of molecular aberrations and oncogenic drivers in NSCLC, it is expected that more and more patients will benefit from orally small targeted therapies in NSCLC. However, their concomitant or sequential use is associated with an increased risk of a various toxicity pattern.Relevant publications were included if they reported data on the question of toxicities associated with sequential or combined use of ICIs and small targeted therapies used in NSCLC treatment. MEDLINE, Google Scholar, and the Cochrane Library were searched for the following request, from database inception until June 2023.This review highlighted a various pattern of toxicities (i.e., interstitial lung disease, hepatitis, dermatoses) in the context of both sequential and concomitant administration of ICIs and small targeted therapies. Such toxicities seem rather a "drug-effect" than a "class-effect" and some of these toxicities are more specific of a small targeted therapy. This review highlights on the impact of treatment sequence administration and emphasis for physicians to be particularly careful whether small targeted therapy is administered within one to three months after last ICIs injection.Physicians have to be aware of severe toxicities in case of both concomitant or sequential ICIs/small targeted therapies administration in NSCLC. Further studies are needed to better understand the mechanisms underlying these toxicities in order to prevent them and to refine ICIs and small targeted therapy sequencing strategy.Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.