Association of immune‐related pneumonitis with clinical benefit of anti‐programmed cell death‐1 monotherapy in advanced non‐small cell lung cancer

Ono, Kana; Ono, Hirotaka; Toi, Yukihiro; Sugisaka, Jun; Aso, Mari; Saito, Ryoichi; Kawana, Sachiko; Aiba, Tomoiki; Odaka, Tetsuo; Matsuda, Suguru; Saito, Shin; Narumi, Akane; Ogasawara, Takahiro; Shimizu, Hisashi; Domeki, Yutaka; Terayama, Keisuke; Kawashima, Yosuke; Nakamura, Atsushi; Yamanda, Shinsuke; Kimura, Yuichiro; Honda, Yoshihiro; Sugawara, Shunichi

doi:10.1002/cam4.4045

Cited by 14 publications

(25 citation statements)

References 36 publications

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“…The occurrence of irAEs indicates that immunotherapy has activated the immune system of patients. Patients with greater toxicity to immune drugs can attain better curative effects, leading to prolonged PFS and OS ( 20 ). In a meta-analysis ( 74 ), irAEs, especially endocrine, dermatologic and low-grade irAEs, were significantly associated with better ICI outcomes in patients with cancer.…”

Section: Discussionmentioning

confidence: 99%

“…According to the data of clinical trials, the incidence of ICI-P is 3%—6.3% in NSCLC, and the mortality rate is <1% ( 14 – 16 ). However, in previous epidemiological studies, the incidence of ICI-P varied greatly, ranging from 2.7% to 19% in NSCLC ( 17 – 20 ) ( Table 1 ). Patients with lung cancer are more likely to develop ICI-P than patients with other types of cancer ( 17 ).…”

Section: Introductionmentioning

confidence: 93%

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Immune checkpoint inhibitor-related pneumonitis in non-small cell lung cancer: A review

Hao

Zhang

2022

Front. Oncol.

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Immune checkpoint inhibitors (ICIs) have shown definite therapeutic effects in various types of cancers, especially non-small cell lung cancer (NSCLC). However, ICIs have unique side effects, called immune-related adverse events (irAEs), which can occur in various systems throughout the body. Among such irAEs, immune checkpoint inhibitor-related pneumonitis (ICI-P) is a fatal adverse reaction. In this review, we discussed the risk factors, pathogenesis, clinical characteristics, radiological manifestations, pathological features, diagnosis, grading, and management of ICI-P in NSCLC and the relationship between ICI-P and the efficacy of ICI therapy. In addition, we discussed the predictive factors for ICI-P. This review will play a crucial role in the prediction, evaluation, and management of ICI-P for widespread application of immunotherapy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 93%

Immune checkpoint inhibitor-related pneumonitis in non-small cell lung cancer: A review

Hao

Zhang

2022

Front. Oncol.

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“…The same is true with skin reactions and pneumonitis. 18 , 19 However, the reasons why the development of any irAE is associated with tumor response remain unknown. Further research is warranted to uncover the reason for this association.…”

Section: Discussionmentioning

confidence: 99%

Incidence, Clinical Characteristics, and Predictors of Cardiovascular Immune-Related Adverse Events Associated with Immune Checkpoint Inhibitors

et al. 2022

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Background Cardiovascular immune-related adverse events (CV–irAEs) associated with immune checkpoint inhibitors (ICIs) may have been underreported given that most previous reports were retrospective. We aimed to evaluate the incidence, clinical characteristics, and predictors of CV–irAEs and determine the feasibility of serial cardiac monitoring using a combination of B-type natriuretic peptide, cardiac troponin T, and electrocardiogram for the prediction of future symptomatic (grade ≥2) CV–irAEs. Materials and Methods This was a prospective observational study that included 129 consecutive patients with non–small-cell lung cancer who received ICI monotherapy at a single center. Serial cardiac monitoring was performed during ICI monotherapy. Results A total of 35 (27%) patients developed any grade ≥1 CV–irAEs with a median time of onset of 72 (interquartile range 44-216) days after ICI treatment initiation. Multivariate Fine–Gray regression analysis showed that prior acute coronary syndrome (adjusted hazard ratio [HR] 3.15 (95% [CI], 2.03-4.91), prior heart failure hospitalization (adjusted HR 1.65 [95% CI, 1.17-2.33]), and achievement of disease control (adjusted HR 1.91, [95% CI, 1.16-3.14]) were significantly associated with grade ≥1 CV–irAEs. Serial cardiac monitoring revealed that patients with preceding grade 1 CV–irAEs were associated with a significantly higher risk of onset of grade ≥2 CV–irAEs compared with those without preceding grade 1 CV–irAEs (HR: 6.17 [95% CI, 2.97-12.83]). Conclusion CV–irAEs were more common than previously recognized and have several predictors. Moreover, serial cardiac monitoring may be feasible for the prediction of future grade ≥2 CV–irAEs.

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“…In CIP patients, Suresh et al 3 demonstrated that although ICIs did not significantly affect short‐term survival including disease control rate, overall response rate, and PFS, it would decrease the overall survival(OS) by 10 months. Another study reported that CIP increased PFS and OS, and 25% of patients continued to have no tumor growth after treatment discontinuation 76 . In real world studies, CIP is associated with poor prognosis 3,9 .…”

Section: Consensus 9: the Prognosis Of Cipmentioning

confidence: 99%

“…Another study reported that CIP increased PFS and OS, and 25% of patients continued to have no tumor growth after treatment discontinuation. 76 In real world studies, CIP is associated with poor prognosis. 3 , 9 On the other hand, the efficacy of ICI in patients with irAEs has improved.…”

Section: Consensus 9: the Prognosis Of Cipmentioning

confidence: 99%

Chinese expert consensus on the multidisciplinary management of pneumonitis associated with immune checkpoint inhibitor

Wang

et al. 2022

Thoracic Cancer

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Immune checkpoint inhibitors (ICIs) have successfully treated a number of different types of cancer, which is of great significance for cancer treatment. With the widespread use of ICIs in clinical practice, the increasing checkpoint inhibitor pneumonia (CIP) will be a challenge to clinicians. To guide the diagnosis and treatment of CIP, we conducted in-depth discussions based on the latest evidence, forming a consensus among Chinese experts on the multidisciplinary management of CIP. K E Y W O R D S checkpoint inhibitor pneumonitis, Chinese experts consensus, immune checkpoint inhibitor-related adverse effectsWenxian Wang, Qian Wang and Chunwei Xu, contributed equally to this study.

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Association of immune‐related pneumonitis with clinical benefit of anti‐programmed cell death‐1 monotherapy in advanced non‐small cell lung cancer

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 14 publications

References 36 publications

Immune checkpoint inhibitor-related pneumonitis in non-small cell lung cancer: A review

Immune checkpoint inhibitor-related pneumonitis in non-small cell lung cancer: A review

Incidence, Clinical Characteristics, and Predictors of Cardiovascular Immune-Related Adverse Events Associated with Immune Checkpoint Inhibitors

Chinese expert consensus on the multidisciplinary management of pneumonitis associated with immune checkpoint inhibitor

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