Author of

• 20171

  +

  P2.07 - Immunology and Immunotherapy (ID 708)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: Immunology and Immunotherapy
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 23377

    +

    P2.07-002 - Drug-Related Pneumonitis in Advanced Non-Small-Cell Lung Cancer (NSCLC) Patients Treated with Commercial PD-1 Inhibitors (ID 7559)

    09:30 - 09:30  |  Author(s): T. Hida
    • Abstract

    Background:
    PD-1 inhibitor-related pneumonitis is recognized as a serious immune-related adverse event especially among NSCLC patients. The study investigated the radiographic patterns, clinical course, and risk factors of pneumonitis in advanced NSCLC patients treated with commercial PD-1 inhibitors.
    
    Method:
    The study included 210 patients (93 men, 117 women; median age: 65) with advanced NSCLC treated with commercially prescribed single-agent nivolumab or pembrolizumab. Chest CT scans during therapy were reviewed for abnormalities suspicious for pneumonitis by an independent review of two radiologists. Radiographic patterns of pneumonitis were classified using the ATS/ERS classification of interstitial pneumonia.
    
    Result:
    Pneumonitis was radiographically detected in 20 patients (20/210; 9.5%). Median time from the initiation of therapy to pneumonitis was 7.8 weeks. The radiographic pattern of pneumonitis was a cryptogenic organizing pneumonia (COP) pattern in 18, a non-specific interstitial pneumonia (NSIP) pattern in one, and a hypersensitivity pneumonitis (HP) pattern in one patient. Fifteen patients (75%) were symptomatic and 5 patients (25%) were asymptomatic with radiographic abnormalities alone. PD-1 inhibitors were held in 17 patients (85%), and corticosteroids were given in 12 patients (60%). Seven patients were hospitalized for treatment of pneumonitis. Three patients were re-treated with PD-1 inhibitors and two developed recurrent pneumonitis. There were no significant differences in clinical characteristics between patients with and without pneumonitis (p>0.34). Figure 1
    
    
    
    Conclusion:
    PD-1 inhibitor-related pneumonitis was noted in 9.5% of the advanced NSCLC patients treated with commercially prescribed PD-1 inhibitors. Radiographic pattern of pneumonitis was most commonly a COP pattern. Recurrent pneumonitis was common among those who were re-treated with PD-1 inhibitors. Further studies are necessary to identify risk factors for pneumonitis.