Radiographic features and prognosis of early- and late-onset non-small cell lung cancer immune checkpoint inhibitor-related pneumonitis

作者：Aiben Huang, Yang Xu, Xuelei Zang, Chongchong Wu, Jie Gao, Xiaoli Sun, Mei Xie, Xidong Ma, Hui Deng, Jialin Song, Fangping Ren, Li Pang, Jin Qian, Zhaofeng Yu, Shiyu Wan, Yuanyuan Chen, Lei Pan, Guanglei Zhuang, Sanhong Liu, Xinying Xue · 发表于：BMC Cancer · 年份：2021 · DOI：10.1186/s12885-021-08353-y · 被引用次数：32 · 研究领域：Cancer Immunotherapy and Biomarkers、Lung Cancer Research Studies、Lung Cancer Diagnosis and Treatment

BACKGROUND: Immunotherapy is becoming a standard of care for non-small cell lung cancer (NSCLC). Checkpoint inhibitor-associated pneumonia (CIP) is a rare and potentially life-threatening event that can occur at any time during tumor immunotherapy. However, there may be differences in the radiological patterns and prognosis of CIP during different periods. This study aimed to investigate the radiographic features and prognosis of early- and late-onset immune-related pneumonitis. METHODS: We retrospectively analyzed the clinical data of 677 NSCLC patients receiving immunotherapy to identify 32 patients with CIP, analyzed the clinical and radiographic data, and summarized the radiological features and prognosis of early- and late-onset CIP. RESULTS: CIP had an incidence of 4.7%, a median onset time of 10 weeks, and a mortality of 28.1%. Among these, CIP included 14 early-onset cases, where grade ≥ 3 CIP accounted for 92.9%, main radiographic pattern was organizing pneumonia (OP)-like pattern, and mortality was 50.0%. We also identified 18 late-onset CIPs, where grade ≥ 3 CIP accounted for 50.0%, main radiographic pattern was nonspecific interstitial pneumonia (NSIP)-like pattern, and mortality was 11.1%. The overall survival rate of the early-onset group was significantly lower than that of the late-onset group (P < 0.05). CONCLUSION: Early-onset CIP cases were higher in the Common Terminology Criteria for Adverse Events (CTCAE v5.0) grade and mainly presented with an OP-like r...