Radiographic features and poor prognostic factors of interstitial lung disease with nivolumab for non–small cell lung cancer

Abstract

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Treatment and relapse of interstitial lung disease in nivolumab‐treated patients with non–small cell lung cancer

“…The patient who died after a relapse had a non–DAD‐like pattern at initial ILD and at time of relapse but had progressed to a DAD‐like pattern before death. This was consistent with our primary manuscript, which showed that a DAD‐like pattern is one of the poor prognostic factors 8 …”

“…This was consistent with our primary manuscript, which showed that a DAD-like pattern is one of the poor prognostic factors. 8 The main strength of this study is that it examined patients with NSCLC who were treated with nivolumab and experienced ILD in a real-world setting, and, therefore, the data are generalizable to the Japanese population. This study also had a sufficiently large sample size, and ILD-related data for each patient were carefully assessed by a group of experts to ensure that the ILD experienced by patients was due to nivolumab treatment.…”

“…This was a retrospective cohort study based on a post–marketing study of patients with NSCLC treated with nivolumab in Japan. Further details are described in a separate report 8 …”

“…This study was part of a post–marketing study of patients with NSCLC in Japan treated with nivolumab. A previous part of the post–marketing study evaluated radiographic characteristics and poor prognostic factors of ILD and found that a diffuse alveolar damage (DAD)‐like radiographic pattern, onset of ILD ≤60 days from nivolumab initiation, pleural effusion before nivolumab treatment, lesion distribution contralateral or bilateral to the tumor, and abnormal changes in C‐reactive protein levels were indicative of a poor prognosis 8 . These results may help physicians observe the clinical course of nivolumab‐induced ILD more carefully and provide improved care, especially to patients with poor prognostic factors.…”

Incidence and prognostic factors in severe drug-induced interstitial lung disease caused by antineoplastic drug therapy in the real world

“…The mortality rate was significantly higher in the group with the DAD pattern (DAD, 53.3% vs. non-DAD, 13.3%). Among the previous reports, only one observational study examining nivolumab-induced DILD reported the DAD pattern as a statistically significant predictor of a poor prognosis (Saito et al 2020 ). The high mortality rate in patients with the DAD pattern agrees with the findings of previous reports on DILD (40–83.3%) (Gemma et al 2014 , 2019 , 2020 ; Shi et al 2014 ; Hotta et al 2010 ; Tomii et al 2017 ).…”