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

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Video Summary

Dr. Prabhat Malik, a medical oncologist from All India Institute of Medical Sciences, discusses immune checkpoint inhibitor pneumonitis, a rare yet serious condition requiring careful monitoring in cancer therapy. Despite its low incidence of 2.7% across tumor types, a higher incidence is noted in non-small-cell lung cancer. Patients treated with anti-PD-1 or PD-L1 inhibitors, especially in combination with other drugs, bear a higher risk. Risk factors include pre-existing lung conditions, prior chest radiation, and active smoking. The condition mainly results from T-cell activation and an inflammatory response. Symptoms include dyspnea, cough, and fever, and the condition can range from asymptomatic to severe, requiring oxygen or intensive care. Management involves adjusting immunotherapy and using steroids or immunosuppressants as needed. Although re-challenging with therapy is possible for some patients, caution and close monitoring are necessary to address potential relapses or complications.

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Prabhat Malik, MD

Keywords

immune checkpoint inhibitor pneumonitis

non-small-cell lung cancer

anti-PD-1 inhibitors

T-cell activation

cancer therapy management