Anti-PD1–Induced Pneumonitis: Capturing the Hidden Enemy

Castañón, Eduardo

doi:10.1158/1078-0432.ccr-16-2033

Cited by 11 publications

(10 citation statements)

References 12 publications

(12 reference statements)

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“…To meet increasing demands for early detection, accurate diagnosis, and optimal monitoring of complications of precision cancer therapies in state-of-the-art cancer care, radiologists should have practical strategies to approach each category of major complications (77,78). Although further efforts are needed to establish such strategies, a combination of diagnostic imaging clues and clinical dialogue in the context of precision oncology can contribute to fulfilling our mission on the multidisciplinary cancer care team (Fig 21).…”

Section: Radiologist's Approach As a Member Of The Multidisciplinary mentioning

confidence: 99%

Thoracic Complications of Precision Cancer Therapies: A Practical Guide for Radiologists in the New Era of Cancer Care

et al. 2017

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Recent advances in understanding the molecular mechanisms of cancer have opened a new era of precision medicine for cancer treatment. Precision cancer therapies target specific molecules that are responsible for cancer development and progression, and they achieve marked treatment benefits in specific cohorts of patients. However, these therapies are also associated with a variety of complications that are often unique to specific groups of anticancer agents. The rapidly increasing use of immune checkpoint inhibitors in the treatment of various advanced malignancies has brought new challenges in diagnosing and monitoring a unique set of toxic effects termed immune-related adverse events. Familiarity with cutting-edge cancer treatment approaches and awareness of the emerging complications from novel therapies are essential for radiologists, who play a key role in the care of patients with cancer. This article provides a comprehensive review of the thoracic complications of precision cancer therapies, describes their imaging features and clinical characteristics, and discusses the role of radiologists in the diagnosis and monitoring of these entities. The authors also address the molecular mechanisms of anticancer agents that relate to thoracic complications and emphasize emerging challenges in novel cancer therapies. This article is designed to serve as a practical reference guide for day-to-day practice for radiologists in the era of precision cancer medicine. RSNA, 2017.

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Section: Radiologist's Approach As a Member Of The Multidisciplinary mentioning

confidence: 99%

Thoracic Complications of Precision Cancer Therapies: A Practical Guide for Radiologists in the New Era of Cancer Care

et al. 2017

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“…Management of pneumonitis is based on the grade attributed by clinicians using the CTCAE definitions [ 19 ]. Treatment options include observation, oral or intravenous corticosteroids, cessation of immunotherapy, and, in refractory cases, the use of immunosuppression drugs including mycophenolate, infliximab, and cyclophosphamide [ 11 , 13 ]. Patients may require admission to hospital and respiratory support in a high-dependency or intensive care unit.…”

Section: Discussionmentioning

confidence: 99%

“…The mainstay of therapy is corticosteroids; however, steroid-refractory cases challenge clinicians’ decisions regarding the appropriate dose, timing, and route of administration [ 19 ]. Steroid-sparing agents are often employed in the case of steroid refractoriness; however, there appears to be limited data on the efficacy of these treatments [ 11 ]. The length of treatment and weaning regime implemented can also be a challenge with rebound toxicity on withdrawal of steroids [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…Initial treatment is often empiric. Treatment options include supportive therapy alone, oral or intravenous corticosteroids, cessation of immunotherapy, and, in refractory cases, the use of steroid-sparing agents as part of prolonged immunosuppression with mycophenolate, infliximab, or cyclophosphamide [ 11 , 13 ]. The outcome of patients who develop pneumonitis can range from complete resolution to death [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Patterns of immunotherapy-induced pneumonitis in patients with non-small-cell lung cancer: a case series

et al. 2021

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Background Immunotherapy has become an efficacious option in the management of solid organ malignancies. Immune-related adverse events including pneumonitis are well described and may be particularly of concern in patients receiving immunotherapy for non-small-cell lung cancer. Case presentations In this paper, we describe three cases of immunotherapy-induced pneumonitis occurring in the management of lung malignancy. Our cases include a 54-year-old Caucasian woman with squamous cell lung cancer who was successfully rechallenged with immunotherapy after prior significant pneumonitis, a 65-year-old Caucasian man with metastatic squamous cell lung cancer who developed pneumonitis after multiple cycles of uneventful immunotherapy, and a 73-year-old Caucasian man with squamous cell lung cancer who developed early-onset pneumonitis with rebound on steroid taper. Conclusions This case series has provided further insight into the presentation and risk factors for pneumonitis in patients with non-small-cell lung cancer. Each of the cases of immunotherapy-induced pneumonitis illustrates the different potential patterns that may arise when immunotherapy-induced pneumonitis develops. This case series provides key learning points that may assist physicians managing non-small-cell lung cancer with immunotherapy.

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“…Immunotherapeutic pneumonia may present as nonspecific interstitial pneumonia, allergic pneumonia, acute interstitial pneumonia, or cryptogenic pneumonia. If still uncertain, bronchoscopy and bronchoalveolar lavage (BAL) should be performed (24).…”

Section: Pulmonary Toxicitiesmentioning

confidence: 99%

Toxicity of tumor immune checkpoint inhibitors—more attention should be paid

Liu

Wang

Deng

et al. 2019

Transl Lung Cancer Res

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In recent years, immunotherapy, especially immune checkpoint inhibitors (ICIs), has achieved amazing results in the treatment of lung cancer, melanoma, renal clear cell carcinoma and other malignant tumors. Although ICIs have achieved significant efficacy in tumor treatment, the immune-related adverse events (irAEs) caused by non-specific immune activation of ICIs can directly affect the result of treatment, even threaten the life of patients. The most common form of irAEs involve the skin, lung, colon, liver and endocrine organs. However, it is noticeable that although irAEs of some organs are more common, actually any organ and tissue are likely to be affected, because of non-specific activation of the immune system.Other tissues and organs, though rare, can be more severe and even fatal, such as neurological disorders and myocarditis. Therefore, effective management of irAEs is of great importance for the efficacy of immunotherapy. This review is focused on the morbidity, clinical manifestations, diagnosis and treatment of tumor immune toxic effects.

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Anti-PD1–Induced Pneumonitis: Capturing the Hidden Enemy

Cited by 11 publications

References 12 publications

Thoracic Complications of Precision Cancer Therapies: A Practical Guide for Radiologists in the New Era of Cancer Care

Thoracic Complications of Precision Cancer Therapies: A Practical Guide for Radiologists in the New Era of Cancer Care

Patterns of immunotherapy-induced pneumonitis in patients with non-small-cell lung cancer: a case series

Toxicity of tumor immune checkpoint inhibitors—more attention should be paid

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