Best Practices and Research Advances in Thoracic Oncology: A Regional Series Eastern Europe/Baltic Course 2: Immunotherapy in Lung Cancer-Pneumonitis: The Big Elephant in the Room

Video Transcription

Video Summary

Dr. Inbal Shafran discusses pneumonitis, emphasizing its complex diagnosis and management. Using a case of a 43-year-old colon cancer patient on pembrolizumab, the video highlights the challenges in diagnosing pneumonitis due to its varied clinical and radiological presentations, often resembling infections. Initial management typically involves discontinuing the suspected drug and administering high-dose steroids, though over-diagnosis and associated side effects like impaired wound healing are concerns. Dr. Shafran notes that there can be over-diagnosis, with factors such as drug combinations contributing to increased pneumonitis rates. The absence of definitive diagnostic signs complicates matters, often leading to empiric treatments and potential cessation of effective therapies. Decision-making regarding re-challenging with the offending drug requires a personalized approach, weighing treatment benefits and patient response. The video concludes by encouraging careful symptom monitoring and multi-disciplinary discussions to minimize misdiagnoses and improve patient outcomes.

Asset Subtitle

Inbal Shafran, MD

Keywords

pneumonitis

diagnosis

management

pembrolizumab

steroids

over-diagnosis