Programmed cell death 1 (PD-1)/PD-ligand 1(PD-L1) inhibitors-related pneumonitis in patients with advanced non-small cell lung cancer.

Abstract

Immune‐related pneumonitis is an uncommon but potentially fatal immune‐related adverse event in advanced non–small cell lung cancer (NSCLC) patients during treatment with anti‐programmed cell death 1 (PD‐1) and programmed cell death‐ligand 1 (PD‐L1). Underlying emphysema, interstitial lung disease (ILD), and previous radiation therapy for lung cancer might be factors precipitating immune‐related pneumonitis. The incidence of immune‐related pneumonitis is reported to be higher in those treated with PD‐1 inhibitors than in those treated with anti‐PD‐L1 inhibitors. Early detection and diagnosis and appropriate management according to the severity are critical to improving the prognosis. The first‐line physicians, including the primary responsible oncologists, family doctors, emergency physicians and NSCLC patients should be trained to identify and report symptoms of immune‐related pneumonitis as early as possible. Multidisciplinary treatment teams involving clinicians (including ILD specialists and lung cancer specialists), radiologists and pathologists are recommended for the treatment of immune‐related pneumonitis.