Rate and risk factors of recurrent immune checkpoint inhibitor-related pneumonitis in patients with lung cancer

作者：Haitao Tao, Fangfang Li, Dongxiao Wu, Shiyu Ji, Qingyan Liu, Lijie Wang, Bo Liu, Francesco Facchinetti, Tracy L. Leong, Francesco Passiglia, Yi Hu · 发表于：Translational Lung Cancer Research · 年份：2022 · DOI：10.21037/tlcr-22-168 · 被引用次数：24 · 研究领域：Cancer Immunotherapy and Biomarkers、Lung Cancer Research Studies、Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis

Background: Immune checkpoint inhibitors (ICIs) have become standard treatments for lung cancer patients. Immune checkpoint inhibitor-related pneumonitis (CIP) was the leading cause of death among ICIs-related adverse events (irAEs). Recurrent episodes of CIP without rechallenge of ICIs were reported in several cases and maybe a unique feature of CIP. Knowledge gaps remain regarding the rate and risk factors associated to CIP's recurrence. Methods: Data from 1,102 lung cancer patients receiving ICIs treatment between January 2016 and January 2021 were retrospectively collected and analyzed. CIP was diagnosed according to typical clinical features and/or new typical imaging changes. Recurrence of CIP (CIP-R) was defined as recurrent CIP after initial CIP improved after proper treatment. Logistic regression was used to assess risk factors associated with CIP recurrence. Results: Eighty out of 1,102 (7.26%) patients were diagnosed with CIP. Twenty of those 78 (25.64%) patients suffered CIP-R, 2 patients died and were therefore excluded from the denominator. The median onset of initial pneumonitis for patients without and with recurrence was 3.49 months [interquartile range (IQR), 0.26-31.93 months] and 2.78 months (IQR, 1.22-20.93 months), respectively (P=0.48). The median interval duration between initial CIP and CIP-R was 1.54 months (IQR, 0.98-16.70 months). Recurrence of CIP was more common in males (P=0.03), squamous histology (P=0.016), and in patients who received chest r...