Abstract
Immunotherapy has become a standard of care in oncology, following the recent approvals of cytotoxic T-lymphocyte-associated protein-4 and programmed cell death-1 inhibitors in lung cancer, melanoma, renal cell carcinoma, Hodgkin's lymphoma, bladder, head and neck cancers. Besides their efficacy, these agents also generate specific immune-related adverse events. Due to the increasing prescription of immune-checkpoint inhibitors, the incidence of immune toxicity will continue to rise. The awareness of immune-related adverse events is key to ensuring both diagnosis and management of the possible serious adverse events. Although severe immune-related adverse events remain rare, they can lead to discontinued treatment or to death if they are not forecasted and managed properly. Even if lung toxicity is not the most frequent adverse event, it remains critical as it can be life-threatening. Herein, the main aspects of pulmonary toxicity are reviewed and guidelines are also proposed in order to manage the possible side-effects.
Abstract
Immune-related lung toxicity can be life-threatening. Early recognition and management including CT scan and bronchoscopy should be encouraged. Treatment mainly relies on steroids. In addition, re-challenge should be discussed in multidisciplinary boards. http://bit.ly/2WNYH8I
Footnotes
Provenance: Submitted article, peer reviewed.
Conflict of interest: M. Delaunay has nothing to disclose.
Conflict of interest: G. Prévot has nothing to disclose.
Conflict of interest: S. Collot has nothing to disclose.
Conflict of interest: L. Guilleminault has nothing to disclose.
Conflict of interest: A. Didier has nothing to disclose.
Conflict of interest: J. Mazières reports grants and personal fees from AstraZeneca, BMS and Roche, and personal fees from Novartis, MSD, Pfizer and Pharmamar, outside the submitted work.
- Received February 12, 2019.
- Accepted June 8, 2019.
- Copyright ©ERS 2019.
This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.