3 years ago

Pneumonitis in Irradiated Lungs After Nivolumab: A Brief Communication and Review of the Literature

Li, Minglun, Dantes, Maurice, Roengvoraphoj, Olarn, Marschner, Sebastian, Manapov, Farkhad, Eze, Chukwuka
Nivolumab is a feasible therapy option in patients with advanced non–small cell lung cancer (NSCLC) who progress on first-line treatment. However, there is limited information about an overlapping toxicity of PD-1 inhibitors when administered following thoracic radiotherapy (TRT). Three of 25 patients with advanced NSCLC were treated with palliative or curative intent. Nivolumab was initiated as second or third-line therapy after TRT for recurrent or progressive disease. All 3 patients developed grade 3 pneumonitis at some point during nivolumab therapy. Herein, we describe 3 cases of pneumonitis in patients with NSCLC started on nivolumab following TRT. Imaging analysis was strongly consistent with heterogenous lung parenchyma changes in the irradiated lung volume receiving a total dose of 15–20 Gy. Pulmonary toxicity was manageable; however, interruption of immunotherapy was necessary.
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