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Identifying PD-1/PD-L1 Inhibitors with Surface Plasmon Resonance Technology
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Pulmonary Toxicity Associated with Immune Checkpoint Inhibitors-Based Therapy: Current Perspectives and Future

Baohui Hong1,2,3, Jiabing Zheng4, Rong Chen5

  • 1Department of Pharmacy, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, 350001, China.

Drug Safety
|November 7, 2023
PubMed

Insights

Immune checkpoint inhibitors (ICIs) can cause pulmonary toxicity. Programmed death 1 (PD-1) plus chemotherapy and PD-1 plus cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) regimens showed the highest risks for treatment-associated pulmonary adverse events.

Area of Science:

  • Oncology
  • Immunotherapy
  • Pulmonary Medicine

Background:

  • Immune checkpoint inhibitors (ICIs) are effective cancer therapies.
  • Pulmonary toxicity risk from ICI regimens is not well-defined.
  • Understanding these risks is crucial for patient safety.

Approach:

  • Conducted a comprehensive search of databases and clinical trial websites (Jan 2015-Dec 2021).
  • Included 104 Phase III randomized clinical trials (RCTs) involving ICI treatments and pulmonary adverse events (PAEs).
  • Analyzed and ranked the incidence and risk of treatment-associated (Tr-PAEs) and immune-mediated (Im-PAEs) pulmonary toxicity.

Key Points:

  • PD-1 + chemotherapy and PD-1 + CTLA-4 regimens had the highest incidence of grades 1-5 Tr-PAEs.
  • PD-1 + CTLA-4 + chemotherapy and PD-L1 + CTLA-4 regimens showed the highest incidence of grades 1-5 Im-PAEs.
  • Nivolumab and atezolizumab exhibited dose-dependent grade 1-2 pulmonary toxicity.

Conclusions:

  • Specific ICI combinations, like PD-1 + chemotherapy and PD-1 + CTLA-4, present the highest risks for pulmonary toxicity.
  • Dose-dependency observed with nivolumab and atezolizumab highlights the need for careful dosing.
  • A targeted management strategy for PAEs is recommended to mitigate risks associated with ICI therapy.

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