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Immune-checkpoint inhibitors associated with interstitial lung disease in cancer patients

2017; European Respiratory Society; Volume: 50; Issue: 2 Linguagem: Inglês

10.1183/13993003.00050-2017

1399-3003

Myriam Delaunay, J. Cadranel, Amélie Lusque, Nicolás Meyer, V. Gounant, Denis Moro‐Sibilot, Jean‐Marie Michot, Judith Raimbourg, Nicolas Girard, Florian Guisier, David Planchard, Anne-Cécile Métivier, Pascale Tomasini, Éric Dansin, M. Pérol, M. Campana, Oliver Gautschi, Martin Früh, Jean-David Fumet, Clarisse Audigier-Valette, S. Couraud, Stéphane Dalle, M.‐T. Leccia, M. Jaffro, S. Collot, Grégoire Prévôt, Julie Milia, Julien Mazières,

Colorectal Cancer Treatments and Studies

Immunotherapy is becoming a standard of care for many cancers. Immune-checkpoint inhibitors (ICI) can generate immune-related adverse events. Interstitial lung disease (ILD) has been identified as a rare but potentially severe event. Between December 2015 and April 2016, we conducted a retrospective study in centres experienced in ICI use. We report the main features of ICI–ILD with a focus on clinical presentation, radiological patterns and therapeutic strategies. We identified 64 (3.5%) out of 1826 cancer patients with ICI–ILD. Patients mainly received programmed cell death-1 inhibitors. ILD usually occurred in males, and former or current smokers, with a median age of 59 years. We observed 65.6% grade 2/3 severity, 9.4% grade 4 severity and 9.4% fatal ILD. The median (range) time from initiation of immunotherapy to ILD was 2.3 (0.2−27.4) months. Onset tended to occur earlier in lung cancer versus melanoma: median 2.1 and 5.2 months, respectively (p=0.02). Ground-glass opacities (81.3%) were the predominant lesions, followed by consolidations (53.1%). Organising pneumonia (23.4%) and hypersensitivity pneumonitis (15.6%) were the most common patterns. Overall survival at 6 months was 58.1% (95% CI 37.7–73.8%). ICI–ILD often occurs early and displays suggestive radiological features. As there is no clearly identified risk factor, oncologists need to diagnose and adequately treat this adverse event.