Pulmonary toxicities of immune check point inhibitors in the management of cancer: mini review

B. Jayakrishnan*, Mansour Al-Moundhri, Ikram Burney, Zamzam Al-Hashami, Khalid Al-Bimani

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Immune-checkpoint inhibitors (ICIs) have revolutionized treatment of solid malignancies, leading in some cases to durable responses. However, an unchecked immune response might lead to mild to severe immune-related adverse events (irAEs). Pulmonary toxicity, though often referred to as Immune checkpoint inhibitor–related pneumonitis (ICI-pneumonitis), covers a broad and overlapping spectrum of pulmonary manifestations and has been described in < 10% of patients receiving ICI either alone or in combination. However, the actual numbers in real-world populations are high, and are likely to increase as the therapeutic indications for ICIs continue to expand to include other malignancies. Drug withdrawal is the mainstay of treatment for ICI-pneumonitis. However, a good number of patients with higher grades of toxicity may need corticosteroids. Patients with refractory disease need additional immunosuppressive agents. In this brief review, we succinctly discuss the incidence, risk factors, mechanisms, clinical and radiologic manifestations, diagnosis and summarize the current management strategies of ICI-pneumonitis.

Original languageEnglish
Pages (from-to)219-229
Number of pages11
JournalAdvances in Respiratory Medicine
Volume90
Issue number3
DOIs
Publication statusPublished - Jun 22 2022
Externally publishedYes

Keywords

  • cancer
  • immune check point inhibitors
  • immunotherapy
  • pulmonary toxicity

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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