Drug-Related Pneumonitis in the Era of Precision Cancer Therapy

Drug-related pneumonitis as a result of novel cancer therapy provides new challenges for providers of cancer care in the era of precision medicine. Awareness of this emerging entity and knowledge of its manifestations and management guidelines are essential for state-of-the-art practice of clinical oncology. Here, we provide a detailed review of drug-related pneumonitis that develops during precision cancer therapies using immune-checkpoint inhibitors and molecular targeting agents, and we summarize the emerging data that have been obtained by recent investigations to provide a state-of-the-art overview for clinicians involved in cancer care. We focus on immune-checkpoint inhibitor-related pneumonitis, which is an immune-related adverse event ofgrowinginterestandincreasing clinical significance in current oncology practice that has rapidly expanding access to these agents. Clinical characteristics, radiographic spectrum, and risk factors and outcome of pneumonitis are described for each class of agents, and current treatment guidelines and monitoring recommendations are discussed. This review also indicates the area of unmet clinical need and provides direction for future investigations, as well as emphasizing the importance of a multidisciplinary approach to further understand the mechanisms, develop methods for accurate diagnosis, and optimize management guidelines of drug-related pneumonitis in the era of precision oncology. (c) 2017 by American Society of Clinical Oncology