Overview of checkpoint inhibitor pneumonitis: incidence and associated risk factors

Expert Opin Drug Saf. 2021 May;20(5):537-547. doi: 10.1080/14740338.2021.1898584. Epub 2021 Mar 10.

Abstract

Introduction: The development of immune checkpoint inhibitors (ICIs) has been a breakthrough in the treatment of several types of cancer. With the widespread use of ICIs in clinical practice, checkpoint inhibitor pneumonitis (CIP) is expected to increase and its management will pose a challenge for clinicians.Areas covered: In this article, we review the incidence, associated risk factors, radiological patterns, clinical features, and management of CIP.Expert opinion: Several clinical trials assessing the efficacy and safety of combination treatments with various drugs and ICIs have been conducted. From the results of these trials, CIP is thought to be an acceptable side effect because the frequency of its development was slightly higher during combination therapies than during ICI monotherapies. However, the risk of developing CIP associated with combinations of chemotherapy and ICIs may be higher in the real world than in clinical trials. Because combinations of chemotherapy and ICIs are associated with increased toxicity, the proper management of immune-related adverse events is necessary to maximize the efficacy of the treatment.

Keywords: Non-small-cell lung cancer; checkpoint inhibitor pneumonitis; immune checkpoint inhibitor (ICI); immune-related adverse events (irAEs).

Publication types

  • Review

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Humans
  • Immune Checkpoint Inhibitors / administration & dosage
  • Immune Checkpoint Inhibitors / adverse effects*
  • Incidence
  • Neoplasms / drug therapy*
  • Pneumonia / chemically induced*
  • Pneumonia / physiopathology
  • Risk Factors

Substances

  • Immune Checkpoint Inhibitors