Pneumonitis Related to Melanoma Immunotherapy

García-Gómez, Francisco Javier; Gala, María C. Álamo-de la; Riva-Pérez, Pablo Antonio de la; Cruz‐Merino, Luis de la; Calvo-Morón, María de la Cinta

doi:10.1097/rlu.0000000000002549

Cited by 8 publications

(3 citation statements)

References 4 publications

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“…While chest radiography may be used as an initial screening tool, chest CT can better depict even subtle changes of pneumonitis and help differentiate among subtypes, which are more completely described in the following section. The role of PET in the diagnosis and follow-up of ICI therapy-related pneumonitis is unclear, although there have been several reports of pneumonitis at PET/CT (28)(29)(30). However, PET lacks in diagnostic specificity in this scenario, given the potential overlap of hypermetabolic activity with malignancy and infectious processes.…”

Section: Clinical Presentationmentioning

confidence: 99%

Immune Checkpoint Inhibitor Therapy–related Pneumonitis: Patterns and Management

et al. 2019

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Abbreviations: AIP = acute interstitial pneumonia, ARDS = acute respiratory distress syndrome, CTCAE = Common Terminology Criteria for Adverse Events, CTLA-4 = cytotoxic T-lymphocyte antigen-4, HP = hypersensitivity pneumonitis, ICI = immune checkpoint inhibitor, irAE = immune-related adverse event, NSIP = nonspecific interstitial pneumonia, OP = organizing pneumonia, PD-1 = programmed cell death protein 1, PD-L1 = programmed cell death ligand 1

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Section: Clinical Presentationmentioning

confidence: 99%

Immune Checkpoint Inhibitor Therapy–related Pneumonitis: Patterns and Management

et al. 2019

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“…Treatment with corticosteroids and pausing cemiplimab for 1 cycle led to a significant improvement of the skin lesions, allowing successful continuation of immunotherapy afterwards. Immunotherapy-associated adverse effects comprise a large array of nonspecific features visible on 18 F-FDG PET/CT, 2 for example, sarcoid-like reaction, 3–5 hypophysitis, 6,7 thyroiditis, 8 pneumonitis, 9,10 colitis, 11 adrenalitis, 12 or pancreatitis 13,14 . Although the more frequent adverse events are well-known today, other less common adverse events, as in our case, may impose diagnostic challenges, particularly with regard to the discrimination from metastases and progressive disease.…”

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confidence: 78%

Immunotherapy (Cemiplimab)-Induced Bullous Pemphigoid

et al. 2021

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A 78-year-old man with multiple squamous cell carcinomas of the skin underwent 18 F-FDG-PET/CT for restaging after 4 cycles of cemiplimab. The scan showed new disseminated FDG-avid skin lesions. Dermatologic examination and biopsy revealed bullous pemphigoid. Discontinuation of cemiplimab and treatment with corticosteroids led to clinical improvement, after which treatment with cemiplimab was resumed. A broad spectrum of inflammatory adverse events can occur in patients treated with immune checkpoint inhibitors, and FDG avidity of these lesions may mimic metastases. Knowledge of such imaging pitfalls is essential for interpreting 18 F-FDG-PET/CT, particularly if they occur in the same organ as the primary tumor.

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“…Clinically, chest radiography is applied as an initial screening method; chest computed tomography (CT) can well depict the subtle changes of pneumonitis and help to distinguish different subtypes. Although there are several case reports of pneumonitis identified on PET, the diagnosis and follow-up of ICP with PET/CT still remains unclear [14,15].…”

Section: Patterns and Diseasementioning

confidence: 99%

Progress in diagnosis and treatment of checkpoint inhibitor pneumonitis

Yu¹,

Wu²,

Su³

2022

Current Opinion in Oncology

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Purpose of reviewIn this article, we summarized the current knowledge of the diagnosis and treatment of the checkpoint inhibitor pneumonitis (CIP), and provide an outlook on the current issues and future prospects.Recent findingsPulmonary toxicity of immunotherapy covers a broad range of pulmonary manifestations and is often referred to as pneumonitis. It is a severe and potentially life-threatening immune-related adverse events (irAEs) that requires early identification and management. The diagnosis of CIP should be carefully distinguished from other forms of pulmonary diseases. Recognizing risk factors and typical symptoms helps to raise suspicion of CIP. Further characterization of the unique radiographic and pathological features is warranted to expedite diagnosis. The identification of potential biomarkers for CIP is emerging and has great relevance in the clinic. Multidisciplinary collaborations involving oncologists, radiologists and pulmonologists may facilitate uniform management strategies. Treatment discontinuation is the mainstay for treating CIP of all grades. Systemic steroids are considered for pneumonitis at least grade 2 and immunosuppressive drugs are recommended for CIP patients refractory to steroids. In the future, more diagnosis and management strategies are needed to provide new insights and treatment options.SummaryThere are achievements and shortcomings in the current status of the diagnosis and treatment for CIP. In the future, the research on this topic should be further demonstrated.

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Pneumonitis Related to Melanoma Immunotherapy

Cited by 8 publications

References 4 publications

Immune Checkpoint Inhibitor Therapy–related Pneumonitis: Patterns and Management

Immune Checkpoint Inhibitor Therapy–related Pneumonitis: Patterns and Management

Immunotherapy (Cemiplimab)-Induced Bullous Pemphigoid

Progress in diagnosis and treatment of checkpoint inhibitor pneumonitis

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