Pulmonary complications of immune checkpoint inhibitors in patients with nonsmall cell lung cancer.
Journal
European respiratory review : an official journal of the European Respiratory Society
ISSN: 1600-0617
Titre abrégé: Eur Respir Rev
Pays: England
ID NLM: 9111391
Informations de publication
Date de publication:
30 Sep 2019
30 Sep 2019
Historique:
received:
24
05
2019
accepted:
23
08
2019
entrez:
11
10
2019
pubmed:
11
10
2019
medline:
21
4
2020
Statut:
epublish
Résumé
Immune checkpoint inhibitor-related pneumonitis (ICI-P) during cancer treatment is rarely observed (<5%). ICI-P is more often observed in patients with nonsmall cell lung cancer (NSCLC) than in those with other cancers. Likewise, it is more common in those receiving programmed cell death (PD)-1/PD-1 ligand inhibitors rather than cytotoxic T-lymphocyte antigen (CTLA)-4 inhibitors alone. The frequency of ICI-P is higher when anti-PD-1 and anti-CTLA-4 are administered concomitantly. Despite the low fatality rate (≈13%), ICI-P is the leading cause of ICI-related deaths. This narrative review focuses on the epidemiology, clinical and radiological presentation and prognosis of ICI-P occurring in patients, especially those with advanced NSCLC. Emphasis is placed on the differences in terms of frequency or clinical picture observed depending on whether the ICI is used as monotherapy or in combination with another ICI or chemotherapy. Other pulmonary complications observed in cancer patients, yet not necessarily immune-related, are reviewed, such as sarcoid-like granulomatosis, tuberculosis or other infections. A proposal for pragmatic management, including differential diagnosis and therapeutic strategies, is presented, based on the ICI-P series reported in the literature and published guidelines.
Identifiants
pubmed: 31597674
pii: 28/153/190058
doi: 10.1183/16000617.0058-2019
pmc: PMC9488121
pii:
doi:
Substances chimiques
Adrenal Cortex Hormones
0
Antineoplastic Agents, Immunological
0
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright ©ERS 2019.
Déclaration de conflit d'intérêts
Conflict of interest: J. Cadranel reports grants and personal fees from AstraZeneca, Novartis and Pfizer, and personal fees from Roche, MSD and BMS, outside the submitted work. Conflict of interest: A. Canellas reports personal fees from BMS, outside the submitted work. Conflict of interest: L. Matton has nothing to disclose. Conflict of interest: M. Darrason has nothing to disclose. Conflict of interest: A. Parrot has nothing to disclose. Conflict of interest: J-M. Naccache has nothing to disclose. Conflict of interest: A. Lavolé has nothing to disclose. Conflict of interest: A-M. Ruppert has nothing to disclose. Conflict of interest: V. Fallet reports personal fees from Bristol Meyers Squib and Lilly, outside the submitted work.
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