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Anti-PD-1 Inhibitor-Related Pneumonitis in Non-Small Cell Lung Cancer
Mizuki Nishino1, Emily S Chambers2, Curtis R Chong2
1Department of Radiology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts. Mizuki_Nishino@dfci.harvard.edu.
Cancer Immunology Research
|February 12, 2016
Summary
PD-1 inhibitors like nivolumab can cause pneumonitis in non-small cell lung cancer (NSCLC) patients. This study details two cases, highlighting characteristic CT findings and successful corticosteroid treatment for this adverse event.
Area of Science:
- Oncology
- Pulmonology
- Radiology
Background:
- The advent of programmed cell death protein 1 (PD-1) inhibitors has revolutionized non-small cell lung cancer (NSCLC) treatment.
- Pneumonitis is a recognized, potentially severe adverse event associated with PD-1 inhibitor therapy.
Observation:
- Two advanced NSCLC patients treated with nivolumab developed anti-PD-1 pneumonitis.
- Radiographic findings included peripheral ground-glass opacities, reticular patterns, and consolidations resembling cryptogenic organizing pneumonia on CT scans.
- Extensive consolidations developed rapidly within 8 weeks of nivolumab initiation.
Findings:
- Corticosteroid therapy led to improvement in respiratory symptoms and radiographic abnormalities in both patients.
- One patient experienced a pneumonitis flare after corticosteroid taper, which resolved with readministration of corticosteroids.
- The clinical and radiographic features of PD-1 inhibitor-related pneumonitis were observed.
Implications:
- Increased awareness of PD-1 inhibitor-related pneumonitis is crucial for early diagnosis and management.
- Understanding the specific clinical and radiographic manifestations aids in differentiating this adverse event from other pulmonary conditions.
- Prompt intervention with corticosteroids can effectively manage PD-1 inhibitor-induced pneumonitis, improving patient outcomes.
