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Clinical Analysis of Relapse Risk in Immune-Checkpoint-Inhibitor-Related Pneumonitis.

Kanae Maruyama1, Mitsuhiro Abe1,2, Takeshi Kawasaki1

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Immune checkpoint inhibitor (ICI)-related pneumonitis (CIP) may relapse. Non-smokers, those with Grade 2 pneumonitis, lower KL-6 levels, and shorter steroid treatment durations were more likely to experience CIP relapse.

Keywords:
checkpoint inhibitor-related pneumonitis (CIP)immune checkpoint inhibitors (ICIs)lung injuryrelapsesteroid therapy

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Area of Science:

  • Oncology
  • Pulmonology
  • Immunology

Background:

  • Immune checkpoint inhibitors (ICIs) can cause pneumonitis (CIP), which may recur despite steroid treatment.
  • Clinical predictors for CIP relapse remain poorly understood.
  • This study aimed to identify factors associated with CIP relapse.

Purpose of the Study:

  • To investigate clinical factors associated with relapse in patients with immune checkpoint inhibitor-related pneumonitis (CIP) during or after steroid treatment.
  • To identify risk factors for CIP recurrence.

Main Methods:

  • Retrospective analysis of 1099 patients receiving ICIs, focusing on 39 who developed CIP and were treated with steroids.
  • Patients were categorized into relapse and non-relapse groups based on CIP recurrence.
  • Comparison of patient characteristics, clinical features, and treatment strategies between groups.

Main Results:

  • Thirteen patients (33.3%) experienced relapse.
  • Relapse was associated with non-smoking status, Common Terminology Criteria for Adverse Events (CTCAE) Grade 2 pneumonitis, and lower serum KL-6 levels.
  • Shorter steroid therapy duration and lower cumulative steroid doses were observed in the relapse group.

Conclusions:

  • Non-smoking, CTCAE Grade 2 pneumonitis, low KL-6, shorter steroid duration, and lower cumulative steroid dose are potential risk factors for CIP relapse.
  • Optimizing steroid dosage and tapering protocols may be crucial for preventing CIP relapse.