Immune-Related Adverse Events: Pneumonitis

Jain, Akash; Shannon, Vickie R.; Sheshadri, Ajay

doi:10.1007/978-3-030-02505-2_6

Cited by 22 publications

(13 citation statements)

References 117 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Drug induced pneumonitis related to conventional chemotherapeutic agents like bleomycin, methotrexate, gemcitabine and taxanes and oral agents like epidermal growth factor receptor tyrosine kinase inhibitors and everolimus is well described [ 1 , 2 ]. Pneumonitis as an immune related adverse event, especially following anti-cytotoxic T lymphocyte associated protein (CTLA) 4 agents is managed with the help of an algorithmic approach [ 3 ]. Improvement in our understanding of the mechanisms and patterns of pulmonary toxicity related to these agents has reflected in our capacity to suspect and recognise this toxicity early.…”

Section: Discussionmentioning

confidence: 99%

CDK 4/6 inhibitor induced lung injury: a case report and review of literature

Mathew¹,

Joel²,

Andrews³

et al. 2021

ecancer

View full text Add to dashboard Cite

Palbociclib is a cyclin dependent kinase (CDK) 4/6 inhibitor that is indicated in combination with an aromatase inhibitor for first-line treatment of hormone receptor-positive, human epidermal growth factor receptor 2 -negative advanced or metastatic breast cancer. The commonly described side effects of palbociclib are neutropenia, anaemia, thrombocytopenia, fatigue, nausea, stomatitis, alopecia, diarrhoea, decreased appetite, vomiting, asthenia, peripheral neuropathy and epistaxis. However, post approval, increasing use of this drug has revealed another potentially fatal complication, in the form of pneumonitis, especially in the Asian population. The PALOMA 3 trial showed that rates of grade 3 and grade 4 adverse events were modestly higher in Asians than non-Asians, though palbociclib exposure was similar in both races. From this, we could infer that adverse effects of this drug must be monitored more specifically in individual racial populations. We report a patient who developed pneumonitis while on palbociclib and discuss the possible mechanisms and management of CDK 4/6 inhibitor-related lung injury.

show abstract

Section: Discussionmentioning

confidence: 99%

CDK 4/6 inhibitor induced lung injury: a case report and review of literature

Mathew¹,

Joel²,

Andrews³

et al. 2021

ecancer

View full text Add to dashboard Cite

show abstract

“…Using clinical symptoms, PFT, and imaging, patients were classified as having airway disease, suspected ILD, ILD, or an alternative diagnosis (Table 1), as described in detail previously [5]. In case of respiratory symptoms, infectious analysis was performed with chest X-ray, sputum culture, that require adequate management to prevent serious morbidity and even mortality [3,4]. Interstitial lung disease (ILD), or non-infectious pneumonitis, is an adverse event of special importance, as it is often hard to discriminate between different causes of respiratory symptoms as well as to decide on safe treatment continuation.…”

Section: Clinical Evaluationmentioning

confidence: 99%

Prospective Study of Drug-induced Interstitial Lung Disease in Advanced Breast Cancer Patients Receiving Everolimus Plus Exemestane

Willemsen¹,

Tol

Erp

et al. 2019

Targ Oncol

View full text Add to dashboard Cite

Background Everolimus-related interstitial lung disease (ILD) (also: pneumonitis) poses a difficulty for physicians, as it is hard to discriminate ILD from other causes of respiratory symptoms and to decide on safe treatment continuation. Objective We investigated the capability of pulmonary function tests (PFT), plasma biomarkers, everolimus pharmacokinetics, and FDG-PET to discriminate between everolimus-related ILD and other causes of respiratory problems and to predict the severity of ILD. Patients and methods Women starting treatment with everolimus plus exemestane for advanced breast cancer were included. At baseline and during the first 3 months, respiratory symptoms, PFT with diffusion capacity of the lungs for carbon monoxide corrected for hemoglobin (DLCOc) and forced vital capacity, serum plasma biomarkers (including SP-D and YKL-40), everolimus trough concentration, and 18 F-FDG-PET were prospectively recorded. Results Twenty-seven (out of 29 included) patients were evaluable for analysis. Fifteen patients (56%) developed everolimusrelated respiratory signs or symptoms and four patients (15%) needed everolimus discontinuation and received corticosteroids. Change in DLCOc differentiated ILD from alternative diagnoses with 0.91 sensitivity and 0.78 specificity. Decrease in DLCOc (non-significant) was greatest in patients who needed everolimus discontinuation. Serum SP-D and YKL-40 could differentiate ILD from alternative diagnoses with 0.83 and 0.83 sensitivity, and 0.85 and 0.62 specificity, respectively. 18 F-FDG-PET abnormalities did not precede clinical symptoms. No relationship between ILD and everolimus trough concentration was found. Conclusions This study shows that everolimus-related ILD occurs frequently. Prospective monitoring of DLCOc in combination with measurement of serum SP-D and YKL-40 appear useful to discriminate ILD from other causes of respiratory symptoms. Clinicaltrials.gov identifier: NCT01978171.

show abstract

“…Considering the long-term survival of ILD-LC patients with driver genes and mutations, TKIs should be administered at the first stage treatments. The application of immune checkpoint inhibitors (ICIs) is a milestone in lung cancer, and the occurrence of immunerelated adverse events (irAEs) such as checkpoint inhibitorrelated pneumonitis (CIPs) is inevitable (Jain et al, 2018). The high mortality rate was observed in severe grade CIPs in NSCLC (Suresh et al, 2018;Tone et al, 2019), and pre-existing ILD is a risk factor for developing CIPs (Kanai et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Management and Prognosis of Interstitial Lung Disease With Lung Cancer (ILD-LC): A Real-World Cohort From Three Medical Centers in China

Xie

Wang

et al. 2021

Front. Mol. Biosci.

View full text Add to dashboard Cite

Background and ObjectiveInterstitial lung disease with lung cancer (ILD-LC) is rare and its management has not been fully described. This study aimed to investigate the management and prognosis of ILD-LC patients in China.MethodsThe present analysis is a retrospective real-world cohort study. Clinical data of ILD-LC patients were obtained from 3 hospitals in China. The overall survival (OS) of patients was analyzed. Univariate and multivariate regression analyses were performed.ResultsOne hundred eighty-four ILD-LC patients included were biased toward male (85.3%), smokers (75.5%), idiopathic pulmonary fibrosis (IPF) (58.2%) patients with comorbidities (67.9%) and ECOG-PS score of 1 (65.2%). Most patients were advanced peripheral non-small cell lung cancer. The initial anti-cancer regimen for ILD-LC is mainly chemotherapy, and patients with early-stage LC prefer surgery. In the anti-cancer cohort, the number of ILD-LC patients who underwent the 2nd and 3rd or more anti-cancer regimens were 78 (55.7%) and 32 (22.8%), respectively. In the non-anticancer cohort, the median OS was 3.5 months. In the early-stage cohort, the median OS was 14.2 months in the systematic therapy group; however, the median OS was not reached in the surgery group. In the advanced-stage cohort with systematic therapy, the median OS was 7.2 months. Interstitial pneumonia (IIP) and anti-angiogenesis were associated with OS in the univariate analysis, whereas anti-angiogenesis was an independent protective factor for advanced LC with ILD.ConclusionPatients with ILD-LC have very poor prognosis. Appropriate anti-tumor treatment can prolong the survival time of patients who can tolerate it. Targeted therapy and immunotherapy are alternative treatments for LC patients with mild ILD. For ILD patients with advanced LC, antiangiogenic regimens significantly improve the prognosis of the disease.

show abstract

Immune-Related Adverse Events: Pneumonitis

Cited by 22 publications

References 117 publications

CDK 4/6 inhibitor induced lung injury: a case report and review of literature

CDK 4/6 inhibitor induced lung injury: a case report and review of literature

Prospective Study of Drug-induced Interstitial Lung Disease in Advanced Breast Cancer Patients Receiving Everolimus Plus Exemestane

Management and Prognosis of Interstitial Lung Disease With Lung Cancer (ILD-LC): A Real-World Cohort From Three Medical Centers in China

Contact Info

Product

Resources

About