Pneumonitis associated with immune checkpoint inhibitors among patients with non-small cell lung cancer

Lung Cancer
26/05/2020

Shannon VR. Curr Opin Pulm Med 2020.

ABSTRACT

PURPOSE OF REVIEW: Patients with lung cancer are particularly vulnerable to lung injury associated with immune checkpoint inhibition and often present with more frequent and more severe manifestations of lung disease compared to patients with other tumor types. The present review explores the reasons for increased susceptibility to immune checkpoint-related lung injury among this group of patients and focuses on the current knowledge of the clinical and radiologic manifestations of lung injury


associated with immune checkpoint blockade and current treatment strategies.

RECENT FINDINGS: Recent investigations have shown that pneumonitis risk associated with immune checkpoint blockade may be stratified according to the tumor type that is being targeted. Patients with lung cancer have the highest rates of pneumonitis associated with this class of agents.

SUMMARY: Pneumonitis associated with immune checkpoint blockade among patients with lung cancer has the highest prevalence of all cancer types. In this patient population, the additional insult to the lungs imposed by immune-checkpoint therapies is often poorly tolerated because of tumor burden within the lung, sequelae from prior treatment and frequent comorbid lung diseases, such as chronic obstructive pulmonary disease. Thus, early recognition and treatment is critical in this patient population to successful outcome.