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Checkpoint Inhibitor Pneumonitis: Mechanisms, Characteristics, Management Strategies, and Beyond

  • Lung Cancer (H Borghaei, Section Editor)
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Abstract

Purpose of Review

Checkpoint inhibitor pneumonitis (CIP) is a toxicity of immune checkpoint blockade (ICB) that can be highly morbid and at times fatal. Here, we review the proposed biologic mechanisms of CIP, epidemiology and risk factors for CIP development, diagnostic work-up and management strategies for CIP, and future directions of CIP research.

Recent Findings

CIP incidence appears to be greater in real-world populations and may continue to rise as FDA approvals for ICB continue to expand to multiple malignancies. Multiple retrospective studies and case series have identified potential risk factors for CIP. Several society guidelines have helped to unify the classification of CIP severity and standardize treatment approaches but significant gaps remain, including formal validated diagnostic criteria for CIP.

Summary

While significant strides have been made in enhancing the knowledge and management of CIP, ongoing research is needed to continue to advance our understanding of the biologic underpinnings of CIP, as well as optimize diagnostic and management strategies for this potentially devastating toxicity.

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Authors and Affiliations

  1. Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Joshua E. Reuss & Jarushka Naidoo

  2. Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University, Baltimore, MD, USA

    Joshua E. Reuss & Jarushka Naidoo

  3. Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, 201 N. Broadway, Viragh Building Box 6, Baltimore, MD, 21287, USA

    Joshua E. Reuss & Jarushka Naidoo

  4. Division of Pulmonary Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Karthik Suresh

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Joshua E. Reuss declares that he has no conflict of interest. Karthik Suresh declares that he has no conflict of interest. Jarushka Naidoo has received research funding from Merck and AstraZeneca; has received compensation from Bristol-Myers Squibb, AstraZeneca, and Roche/Genentech for consulting/advisory board work; and has received honoraria from Bristol-Myers Squibb and AstraZeneca.

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Reuss, J.E., Suresh, K. & Naidoo, J. Checkpoint Inhibitor Pneumonitis: Mechanisms, Characteristics, Management Strategies, and Beyond. Curr Oncol Rep 22, 56 (2020). https://doi.org/10.1007/s11912-020-00920-z

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