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Clinical features, diagnostic challenges, and management strategies in checkpoint inhibitor-related pneumonitis

Authors Chuzi S, Tavora F, Cruz M, Costa R, Chae YK, Carneiro BA, Giles FJ

Received 12 March 2017

Accepted for publication 29 April 2017

Published 14 June 2017 Volume 2017:9 Pages 207—213

DOI https://doi.org/10.2147/CMAR.S136818

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Akshita Wason

Peer reviewer comments 2

Editor who approved publication: Dr Antonella D'Anneo


Sarah Chuzi,1 Fabio Tavora,2 Marcelo Cruz,3 Ricardo Costa,3 Young Kwang Chae,3 Benedito A Carneiro,3 Francis J Giles3

1Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; 2Argos Laboratory, Messejana Heart and Lung Hospital, Fortaleza, Brazil; 3Developmental Therapeutics Program, Division of Hematology/Oncology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

Abstract: Immune checkpoint inhibitors, including cytotoxic T-lymphocyte antigen 4 (CTLA-4) and programmed cell death-1 (PD-1) inhibitors, represent an effective treatment modality for multiple malignancies. Despite the exciting clinical benefits, checkpoint inhibition is associated with a series of immune-related adverse events (irAEs), many of which can be life-threatening and result in significant treatment delays. Pneumonitis is an adverse event of special interest as it led to treatment-related deaths in early clinical trials. This review summarizes the incidence of pneumonitis during treatment with the different checkpoint inhibitors and discusses the prognostic significance of tumor type. The wide range of clinical, radiographic, and histologic characteristics of checkpoint inhibitor-related pneumonitis is reviewed and followed by guidance on the different management strategies.

Keywords: immune checkpoint inhibitors, pneumonitis, anti-PD-1, anti-CTLA-4, immune-related adverse event

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