![]() ![]() 3 4 There is also evidence to suggest that patients with underlying interstitial lung disease (ILD) or interstitial lung abnormalities on baseline chest CT are more likely to develop ICI pneumonitis. There is an increased risk with combination immunotherapy (10%) as opposed to monotherapy (3%) and an increased risk in patients with non-small cell lung cancer (NSCLC) compared with melanoma, head and neck squamous cell carcinoma (SCC) or urothelial carcinoma. 2Ī variety of factors are thought to be associated with the development of ICI-pneumonitis. 1 ICI-related pneumonitis has been reported in 3.5%–19% of patients with significant variability in time to onset ranging from days to years after the first cycle of ICI. Pulmonary toxicity (pneumonitis) is the most commonly fatal irAE from anti-PD-1/PD-L1 monotherapy, accounting for 35% of anti-PD-1/PD-L1 related deaths. ![]() However, these pathways are also important in preventing autoimmunity, and their blockade is therefore associated with significant immune-related adverse events (irAEs). Targets include cytotoxic T-lymphocyte antigen-4 as well as programmed cell death protein-1 (PD-1) and its ligand, PD-L1. These therapies target inhibitory pathways on T cells allowing for increased immune system activation and T cell-mediated clearance of tumour cells. Immune checkpoint inhibitors (ICI) have improved outcomes for patients with many malignancies. ![]()
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