4.3 Review

Overview of checkpoint inhibitor pneumonitis: incidence and associated risk factors

Journal

EXPERT OPINION ON DRUG SAFETY
Volume 20, Issue 5, Pages 537-547

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/14740338.2021.1898584

Keywords

Non-small-cell lung cancer; immune checkpoint inhibitor (ICI); immune-related adverse events (irAEs); checkpoint inhibitor pneumonitis

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The development of immune checkpoint inhibitors has revolutionized the treatment of various cancers, leading to the emergence of checkpoint inhibitor pneumonitis (CIP) as a potential challenge for clinicians. Clinical trials investigating combination therapies with ICIs have shown slightly higher rates of CIP compared to monotherapies, highlighting the importance of proper management of immune-related adverse events to maximize treatment efficacy.
Introduction: The development of immune checkpoint inhibitors (ICIs) has been a breakthrough in the treatment of several types of cancer. With the widespread use of ICIs in clinical practice, checkpoint inhibitor pneumonitis (CIP) is expected to increase and its management will pose a challenge for clinicians. Areas covered: In this article, we review the incidence, associated risk factors, radiological patterns, clinical features, and management of CIP. Expert opinion: Several clinical trials assessing the efficacy and safety of combination treatments with various drugs and ICIs have been conducted. From the results of these trials, CIP is thought to be an acceptable side effect because the frequency of its development was slightly higher during combination therapies than during ICI monotherapies. However, the risk of developing CIP associated with combinations of chemotherapy and ICIs may be higher in the real world than in clinical trials. Because combinations of chemotherapy and ICIs are associated with increased toxicity, the proper management of immune-related adverse events is necessary to maximize the efficacy of the treatment.

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