Dr. Naidoo on Studies of Immune-Related Adverse Events in Lung Cancer

Video

Jarushka Naidoo, MBBCh, assistant professor of oncology, Johns Hopkins University, discusses studies investigating immune-related adverse events for patients with lung cancer.

Jarushka Naidoo, MBBCh, assistant professor of oncology, Johns Hopkins University, discusses studies investigating immune-related adverse events for patients with lung cancer.

In the pneumonitis field, there was a study published in the Journal of Clinical Oncology in 2017 of a collaboration between Memorial Sloan Kettering Cancer Center and the Melanoma Institute of Australia. That series included more than 40 patients with solid tumors who developed pneumonitis as a result of immune checkpoint inhibitors. These were mainly patients with lung cancer and melanoma. What was novel about that study was that it comprehensively reported that pneumonitis can occur at any time during the treatment of a patient with immunotherapy. It has since been reported that this can even occur after immunotherapy has stopped, explains Naidoo.

The other seminal observation, which is highlighted in the guidelines, is that each case of pneumonitis is not all created equal, says Naidoo. There may be variable radiographic appearances associated with it. Clinicians should be aware that if a patient develops a new cough, shortness of breath, fever, or chest pain, and they do a CT scan, that pneumonitis doesn't have a classic appearance. The appearances may range from organizing pneumonia, ground glass opacities, hypersensitivity, interstitial, or not otherwise specified, which is a mix of all 4 of those appearances.

Related Videos
Catherine C. Coombs, MD, associate clinical professor, medicine, University of California, Irvine School of Medicine
Naomi Adjei, MD, MPH, MSEd, gynecologic oncology fellow, The University of Texas MD Anderson Cancer Center
John M. Kirkwood, MD, Distinguished Service Professor of Medicine, Sandra and Thomas Usher Professor of Medicine, Dermatology & Translational Science, coleader, Melanoma and Skin Cancer Program, Division of Hematology/Oncology, the University of Pittsburgh
Nizar M. Tannir, MD, FACP, professor; Ransom Horne, Jr. Professor for Cancer Research, Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center
William B. Pearse, MD
Daniel Olson, MD
Nan Chen, MD
Robert Dreicer, MD, director, Solid Tumor Oncology, Division of Hematology/Oncology, professor of Medicine and Urology, deputy director, University of Virginia Cancer Center
Akriti Jain, MD
Samer A. Srour, MB ChB, MS