Interstitial Lung Disease Spotlight-Checkpoint Inhibitor Pneumonitis: Risk Factors, Diagnosis, and Management

Video Transcription

Video Summary

In this video, the speakers discuss the management of checkpoint inhibitor pneumonitis, a side effect of immunotherapy treatment for cancer. They begin by highlighting the positive impact of immunotherapy in improving long-term survival rates for patients with solid tumors, such as lung cancer and melanoma. They then explain that checkpoint inhibitor pneumonitis can occur in up to 20% of patients undergoing immunotherapy and can range from asymptomatic to life-threatening. The primary treatment for checkpoint inhibitor pneumonitis is to hold therapy and administer high-dose steroids to mitigate inflammation in the lungs. They emphasize the importance of close monitoring and oxygen support as needed. The severity of the pneumonitis determines the treatment approach, with asymptomatic cases requiring only monitoring, mildly symptomatic cases requiring steroids, and severe cases requiring additional agents. The speakers note that the choice of the second agent is challenging due to the lack of evidence, but options such as IVIG and Mycophanate may be considered. Patients who do not improve or have severe disease may require intubation and additional supportive measures. The video concludes by discussing the decision to re-challenge patients after recovering from checkpoint inhibitor pneumonitis, noting that the decision should take into account the patient's need for therapy, the severity of the initial pneumonitis, and any diagnostic uncertainty. Overall, the management of checkpoint inhibitor pneumonitis involves a combination of holding therapy, administering steroids, and providing supportive care.

Meta Tag

Category Diffuse Lung Disease

Speaker Kevin Ho, MD

Speaker Alpa Desai, MD, BS, FCCP

Speaker Douglas Johnson

Keywords

checkpoint inhibitor pneumonitis

immunotherapy treatment

cancer

long-term survival rates

solid tumors

lung cancer

melanoma

high-dose steroids

supportive care