[Immune checkpoint inhibitor-associated pulmonary adverse events]

Area of Science:

• Oncology
• Immunology
• Pulmonology

Background:

• Immune checkpoint inhibitors (ICIs) targeting PD-1, PD-L1, and CTLA-4 have revolutionized cancer treatment.
• ICIs enhance anti-tumor immune responses but can cause immune-related adverse events (irAEs).
• Pulmonary irAEs, particularly ICI-associated pneumonitis (ICI-P), affect up to 20% of patients and can lead to respiratory failure.

Purpose of the Study:

• To summarize the clinical presentation, diagnosis, and management of ICI-associated pneumonitis.
• To highlight the importance of differentiating ICI-P from other pulmonary conditions.

Main Methods:

• Review of clinical presentation including dyspnea, cough, and hypoxemia.
• Radiological findings commonly include organizing pneumonia, NSIP, and bronchiolocentric patterns.
• Management strategies based on severity: treatment interruption, corticosteroids, and second-line immunosuppression.

Main Results:

• ICI-P presents with respiratory symptoms and characteristic radiological findings.
• Management is tailored to severity, involving immunosuppression.
• Differential diagnoses are critical, including infection, tumor progression, and radiation pneumonitis.

Conclusions:

• ICI-P is a significant pulmonary complication of immune checkpoint inhibitor therapy.
• Prompt diagnosis and appropriate management are essential for patient outcomes.
• Awareness of differential diagnoses is crucial for effective treatment of ICI-associated lung injury.