RT Journal Article
SR Electronic
T1 Immune-checkpoint inhibitors associated with interstitial lung disease in cancer patients
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1700050
DO 10.1183/13993003.00050-2017
VO 50
IS 2
A1 Myriam Delaunay
A1 Jacques Cadranel
A1 Amélie Lusque
A1 Nicolas Meyer
A1 Valérie Gounant
A1 Denis Moro-Sibilot
A1 Jean-Marie Michot
A1 Judith Raimbourg
A1 Nicolas Girard
A1 Florian Guisier
A1 David Planchard
A1 Anne-Cécile Metivier
A1 Pascale Tomasini
A1 Eric Dansin
A1 Maurice Pérol
A1 Marion Campana
A1 Oliver Gautschi
A1 Martin Früh
A1 Jean-David Fumet
A1 Clarisse Audigier-Valette
A1 Sébastien Couraud
A1 Stéphane Dalle
A1 Marie-Thérèse Leccia
A1 Marion Jaffro
A1 Samia Collot
A1 Grégoire Prévot
A1 Julie Milia
A1 Julien Mazieres
YR 2017
UL http://erj.ersjournals.com/content/50/2/1700050.abstract
AB Immunotherapy is becoming a standard of care for many cancers. Immune-checkpoint inhibitors (ICI) can generate immune-related adverse events. Interstitial lung disease (ILD) has been identified as a rare but potentially severe event.Between December 2015 and April 2016, we conducted a retrospective study in centres experienced in ICI use. We report the main features of ICI–ILD with a focus on clinical presentation, radiological patterns and therapeutic strategies.We identified 64 (3.5%) out of 1826 cancer patients with ICI–ILD. Patients mainly received programmed cell death-1 inhibitors. ILD usually occurred in males, and former or current smokers, with a median age of 59 years. We observed 65.6% grade 2/3 severity, 9.4% grade 4 severity and 9.4% fatal ILD. The median (range) time from initiation of immunotherapy to ILD was 2.3 (0.2−27.4) months. Onset tended to occur earlier in lung cancer versus melanoma: median 2.1 and 5.2 months, respectively (p=0.02). Ground-glass opacities (81.3%) were the predominant lesions, followed by consolidations (53.1%). Organising pneumonia (23.4%) and hypersensitivity pneumonitis (15.6%) were the most common patterns. Overall survival at 6 months was 58.1% (95% CI 37.7–73.8%).ICI–ILD often occurs early and displays suggestive radiological features. As there is no clearly identified risk factor, oncologists need to diagnose and adequately treat this adverse event.Awareness of clinical/radiological presentation of immunotherapy-related pneumonitis is crucial to ensure a diagnosis http://ow.ly/eIMF30bgolf