Relationship between pneumonitis induced by immune checkpoint inhibitors and the underlying parenchymal status: a retrospective study.

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State: Public
Version: Final published version
License: CC BY-NC 4.0
Serval ID
serval:BIB_58E543FE8A79
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Relationship between pneumonitis induced by immune checkpoint inhibitors and the underlying parenchymal status: a retrospective study.
Journal
ERJ open research
Author(s)
Pozzessere C., Bouchaab H., Jumeau R., Letovanec I., Daccord C., Bourhis J., Prior J.O., Peters S., Lazor R., Beigelman-Aubry C.
ISSN
2312-0541 (Print)
ISSN-L
2312-0541
Publication state
Published
Issued date
01/2020
Peer-reviewed
Oui
Volume
6
Number
1
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
In patients with primary or secondary lung tumour treated with immune checkpoint inhibitors, immune-related pneumonitis is a rare adverse event but may evolve to respiratory failure. Prompt management is required and usually consists of treatment interruption and immunosuppressive drug administration. The aim of this study was to evaluate relationships between immune-related pneumonitis and pre-existing parenchymal status, especially tumour location and history of chest radiotherapy. Computed tomography (CT) scans of patients with immune-related pneumonitis were retrospectively reviewed. Pattern, distribution and extent of pneumonitis were assessed in six lung regions. In patients who received radiotherapy, the extent of pneumonitis was evaluated according to the radiation field. Among 253 patients treated with immunotherapy, 15 cases of immune-related pneumonitis were identified. 10 had previous or concomitant chest radiotherapy in addition to immunotherapy. At CT scan, 29 (33%) out of 88 regions encompassed the primary tumour (n=4), a lung metastasis (n=4) and/or radiation fields (n=21). A significantly higher prevalence of parenchymal involvement by immune-related pneumonitis occurred within areas of primary or metastatic malignancy and/or radiation field (97%) as compared to other areas (3%, p=0.009). Lung regions affected by the primary tumour, metastasis or radiotherapy had a higher probability of immune-related pneumonitis than others (OR 10.8, p=0.024). An organising pneumonia (OP) pattern was more frequent after radiotherapy (70% versus 0%, p=0.024), whereas nonspecific interstitial pneumonia features were more commonly seen in radiotherapy-naive patients (100% versus 10%, p=0.002). In patients with primary or secondary lung tumour treated with immune checkpoint inhibitors, immune-related pneumonitis is preferentially located within lung areas involved by tumour and/or radiation fields.
Pubmed
Web of science
Open Access
Yes
Create date
25/03/2020 17:36
Last modification date
07/11/2020 7:20
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