Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research

5363 - PD-1 inhibitor-related pneumonitis in patients with minimal interstitial lung shadows before treatment

Date

20 Oct 2018

Session

Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research

Presenters

Kosuke Takahashi

Citation

Annals of Oncology (2018) 29 (suppl_8): viii400-viii441. 10.1093/annonc/mdy288

Authors

K. Takahashi, C. Kondo, A. Inukai, G. Asai, M. Okuno, H. Saito

Author affiliations

  • Respiratory Medicine, Aichi Cancer Center Aichi Hospital, 444-0011 - Okazaki/JP
More

Resources

Abstract 5363

Background

Programmed cell death 1 (PD-1) inhibitors have exhibited significant efficacy in various types of cancer including non-small-cell lung cancer (NSCLC). PD-1 inhibitors are expected to be used increasingly as monotherapy or in combination. Pneumonitis is relatively uncommon but potentially fatal toxicity induced by anti PD-1 therapy. Although patients with apparent interstitial pneumonia are excluded from clinical trials of anti PD-1 therapy, patients with minimal interstitial lung opacity on chest CT scans can be treated with PD-1 inhibitors in the clinical practice. Little is known about the incidence of pneumonitis in such cases.

Methods

Among patients with NSCLC treated with PD-1 inhibitors in our institution, we identified those who developed pneumonitis. We reviewed medical records and chest imaging studies. We investigated association between background factors including lung opacities on chest CT scan before anti PD-1 therapy and development of pneumonitis.

Results

We analyzed a total of 79 patients treated with PD-1 inhibitors. At the baseline CT scan, ground glass opacities and reticular opacities were observed in 20 patients (25%) and 18 patients (23%), respectively. All of these interstitial opacities were very mild, and the case of obvious interstitial pneumonia was not observed. During the anti PD-1 therapy, pneumonitis developed in 16 patients (20%). Of the 20 patients with ground glass opacities, ten patients (50%) developed pneumonitis, and of the 18 patients with reticular opacities, nine patients (50%) developed pneumonitis. Ground glass opacities and reticular opacities at baseline were significantly associated with the incidence of pneumonitis (p < 0.001 and p = 0.001, respectively). Among the 49 patients who did not have either of these opacities, three patients (6%) developed pneumonitis. There were no association between pneumonitis and other background factors such as presence of radiation pneumonitis or pulmonary emphysema.

Conclusions

Ground glass opacities and reticular opacities on chest CT scan before treatment can be risk factors of pneumonitis, even if they are mild. For the patients without these opacities, anti PD-1 therapy appears relatively safe.

Clinical trial identification

Legal entity responsible for the study

Aichi Cancer Center Aichi Hospital.

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings
  • Necessary cookies enable core functionality. The website cannot function properly without these cookies, and you can only disable them by changing your browser preferences.