There has been a rapid progress in developing genetically engineered T cells in recent years both in basic and clinical cancer studies. Chimeric antigen receptor (CAR)-T cells exert an immune response against various cancers, including the non-small-cell lung cancer (NSCLC). As novel agents of immunotherapy, CAR-T cells show great promise for NSCLC. However, targeting specific antigens in NSCLC with engineered CAR-T cells is complicated because of a lack of tumor-specific antigens, the immunosuppressive tumor microenvironment, low levels of infiltration of CAR-T cells into tumor tissue, and tumor antigen escape. Meanwhile, the clinical application of CAR-T cells remains limited due to the cases of on-target/off-tumor and neurological toxicity, as well as cytokine release syndrome. Hence, optimal CAR-T-cell design against NSCLC is urgently needed. In this review, we describe the basic structure and generation of CAR-T cells and summarize the common tumor-associated antigens targeted in clinical trials on CAR-T-cell therapy for NSCLC, as well as point out current challenges and novel strategies. Although many obstacles remain, the new/next generation of CARs show much promise. Taken together, research on CAR-T cells for the treatment of NSCLC is underway and has yielded promising preliminary results both in basic and pre-clinical medicine. More pre-clinical experiments and clinical trials are, therefore, warranted.

Bloodstream infection caused by Acinetobacter baumannii has become a major clinical concern, especially multidrug-resistant A baumannii (MDRAB). The aim of this study was to identify the risk factors of nosocomial acquired MDRAB bacteremia and to determine the risk factors related to the mortality of patients with MDRAB bacteremia. Patients with nosocomial acquired A baumannii bacteremia were enrolled between January, 2013 and December, 2017 at the First Affiliated Hospital, School of Medicine, Zhejiang University. Medical records were reviewed, and the clinical and microbial characteristics were collected. Among the 338 patients suffering from A baumannii bacteremia, 274 patients were infected with MDRAB bacteremia. Bacteremia-related mortality was 46.4% for the overall sample; 56.2% for MDRAB bacteremia patients, 4.7% for non-MDRAB bacteremia patients. The identified risk factors for developing MDRAB bacteremia were previous exposure to carbapenems [odds ratio (OR) 5.78, P = .005] and penicillins+β-lactamase inhibitors (OR 4.29, P = .009). Primary bacteremia tended to develop non-MDR bacteremia (OR 0.10, P = .002). The risk factors for MDRAB bacteremia-related mortality were old age (OR 1.02, P = .036), a high Pitt bacteremia score (OR 1.32, P < .001), bacteremia occurring after severe pneumonia (OR 8.66, P < .001), while catheter-related infection (OR 0.47, P = .049) and operations for treating infection (OR 0.51, P = .043) may have a better outcome. Patients with MDRAB had a higher mortality rate. Patients with previous carbapenems and penicillins+β-lactamase inhibitor exposure are at an increased risk of MDRAB bacteremia, whereas patients with primary bacteremia tended to develop non-MDR bacteremia. The risk factors for MDRAB bacteremia-related mortality were old age, a high Pitt bacteremia score, and bacteremia occurring after severe pneumonia, whereas catheter-related infection and operations for the treatment of infection may have a better outcome.

Secondary bacterial infections occurred in 13.9% (5 of 36) of critical ill patients with coronavirus disease 2019. All 5 patients had been admitted to intensive care unit and received mechanical ventilation before developing bacterial infection. Active surveillance of culture should be performed for critically ill patients. Prevention of nosocomial infection should to be taken seriously.

The use of programmed cell-death protein 1 (PD-1)/programmed cell-death ligand 1 (PD-L1) inhibitors is the standard therapy for the first-line or second-line treatment of patients with non-small-cell lung cancer (NSCLC). In contrast to current traditional treatments such as chemotherapy or radiotherapy, anti-PD-1 and anti-PD-L1 treatments can directly attenuate tumour-mediated exhaustion and effectively modulate the host anti-tumour immune response in vivo. In addition, compared with traditional therapy, PD-1/PD-L1 inhibitor monotherapy can significantly prolong survival without obvious side effects in the treatment of advanced NSCLC. Ideally, several biomarkers could be used to monitor the safety and effectiveness of anti-PD-1 and anti-PD-L1 treatments; however, the current lack of optimal prognostic markers remains a widespread limitation and challenge for further clinical applications, as does the possibility of immune-related adverse events and drug resistance. In this review, we aimed to summarise the latest progress in anti-PD-1/anti-PD-L1 treatment of advanced NSCLC, worldwide, including in China. An exploration of underlying biomarker identification and future challenges will be discussed in this article to facilitate translational studies in cancer immunotherapy.