Outcomes of Patients With Interstitial Lung Disease Receiving Programmed Cell Death 1 Inhibitors: A Retrospective Case Series
| Autor: | Daniel Okin, David C. Christiani, Amita Sharma, Sydney B. Montesi, Kristin M. D’Silva, Ioana A. Dobre, Angela J. Frank |
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| Rok vydání: | 2021 |
| Předmět: |
Male
0301 basic medicine Pulmonary and Respiratory Medicine Cancer Research medicine.medical_specialty medicine.medical_treatment Programmed Cell Death 1 Receptor Pembrolizumab behavioral disciplines and activities Article 03 medical and health sciences Idiopathic pulmonary fibrosis 0302 clinical medicine Internal medicine Outcome Assessment Health Care medicine Humans Lung cancer Aged Retrospective Studies Pneumonitis Aged 80 and over business.industry Interstitial lung disease Cancer respiratory system medicine.disease respiratory tract diseases body regions Radiation therapy 030104 developmental biology Oncology 030220 oncology & carcinogenesis Female Nivolumab Lung Diseases Interstitial business |
| Zdroj: | Clin Lung Cancer |
| ISSN: | 1525-7304 |
| DOI: | 10.1016/j.cllc.2021.01.014 |
| Popis: | Background Immune checkpoint inhibitors (ICIs), such as programmed cell death 1 (PD-1) inhibitors, are used to treat multiple cancers. Limited data exist as to the use of ICIs in patients with coexistent interstitial lung disease (ILD). We conducted a retrospective case series to assess clinical and radiologic outcomes of patients with ILD treated with PD-1 inhibitors. Methods Eligible patients were 18 years of age or older, treated with pembrolizumab or nivolumab for oncologic indications, and had evidence of ILD on chest computed tomography scan not attributable to radiotherapy before initiation of ICI therapy. Outcomes of interest included mortality, hospitalizations for respiratory-related causes, development of pneumonitis, and radiologic change in ILD over a 1-year follow-up period. Results We included 41 patients in the analysis. At 1 year, 17 patients (41.5%) were alive, 23 had died (56.1%), and 1 (2.4%) was lost to follow-up. Of 23 deaths, 16 (69.6%) were due to cancer, 4 (17.4%) to causes excluding cancer and ILD, and 3 (13.0%) to hypoxemic respiratory failure from ILD- or ICI-induced pneumonitis. Three patients (7.3%) required hospitalization owing to ILD, including drug-induced pneumonitis, and 3 (7.3%) developed pneumonitis attributable to anti–PD-1 therapy. On follow-up computed tomography scans, 32 patients (78.0%) had stable or improved ILD and 9 (22.0%) had progression. Conclusion Patients with ILD receiving PD-1 inhibitors more frequently died of cancer-related causes than from ILD. Further research is needed to determine the safety of ICIs in patients with ILD and if ILD subtype may help to refine ICI-associated risks. |
| Databáze: | OpenAIRE |
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