Pneumonitis in Non-Small Cell Lung Cancer Patients Receiving Immune Checkpoint Immunotherapy: Incidence and Risk Factors

被引：329

作者：

Suresh, Karthik ^{[1
]}

Khinh Ranh Voong ^{[2
]}

Shankar, Bairavi ^{[3
]}

Forde, Patrick M. ^{[3
,4
]}

Ettinger, David S. ^{[3
]}

Marrone, Kristen A. ^{[3
,4
]}

Kelly, Ronan J. ^{[3
,4
]}

Hann, Christine L. ^{[3
,4
]}

Levy, Benjamin ^{[3
,4
]}

Feliciano, Josephine L. ^{[3
,4
]}

Brahmer, Julie R. ^{[3
,4
]}

Feller-Kopman, David ^{[1
]}

Lerner, Andrew D. ^{[1
]}

Lee, Hans ^{[1
]}

Yarmus, Lonny ^{[1
]}

D'Alessio, Franco ^{[1
]}

Hales, Russell K. ^{[2
]}

Lin, Cheng Ting ^{[5
]}

Psoter, Kevin J. ^{[6
]}

Danoff, Sonye K. ^{[1
]}

Naidoo, Jarushka ^{[3
,4
]}

机构：

[1] Johns Hopkins Univ, Sch Med, Div Pulm Crit Care Med, Baltimore, MD USA

[2] Johns Hopkins Univ, Sch Med, Dept Radiat Oncol, Baltimore, MD USA

[3] Johns Hopkins Univ, Sch Med, Dept Oncol, Baltimore, MD 21205 USA

[4] Johns Hopkins Univ, Bloomberg Kimmel Inst Canc Immunotherapy, Baltimore, MD USA

[5] Johns Hopkins Univ, Sch Med, Dept Radiol, Baltimore, MD 21205 USA

[6] Johns Hopkins Univ, Sch Med, Dept Pediat, Baltimore, MD 21205 USA

来源：

JOURNAL OF THORACIC ONCOLOGY | 2018年 / 13卷 / 12期

关键词：

NSCLC; Immunotherapy; Checkpoint inhibitors; Immune-related adverse events; Checkpoint inhibitor pneumonitis; ADVERSE EVENTS; INHIBITORS; NIVOLUMAB; PEMBROLIZUMAB; DOCETAXEL;

D O I：

10.1016/j.jtho.2018.08.2035

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Checkpoint inhibitor pneumonitis (CIP) is an immune-related adverse event that can occur after initiation of anti-programmed death 1/programmed death ligand 1 immune checkpoint inhibitor (ICI) therapy for the treatment of multiple malignancies, including NSCLC. However, the incidence of CIP has not been previously examined in a population that included both trial-enrolled and non-trial-enrolled patients with advanced NSCLC. Furthermore, risk factors and other clinical characteristics associated with CIP severity are not known. In this study, we retrospectively examined clinical characteristics, incidence, and risk factors for CIP in a cohort of 205 patients with NSCLC, all of whom received anti-programmed death 1/programmed death ligand 1 ICIs. Our results demonstrate a higher incidence of CIP (19%) than previously reported in clinical trials (3%-5%). Our data also suggest that tumor histologic type may be a risk factor for CIP development. We observed a wide range of time to onset of CIP (median 82 days), with high morbidity and mortality associated with higher-grade CIP regardless of degree of immunosuppression. Our data provide new insight into the epidemiology and clinical characteristics of CIP. Further studies are needed to increase CIP pharmacovigilance, improve risk stratification, and refine diagnostic algorithms for the diagnosis and management of this potential life-threatening complication of ICI therapy. (C) 2018 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

引用

页码：1930 / 1939

页数：10

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