Objective: This study aims to determine the frequency of pneumonitis toxicity and its potential risk factors in patients receiving immune checkpoint inhibitors (ICIs) due to various malignancies, with the goal of contributing to the reduction of mortality and morbidity. Material and Methods: A total of 117 patients who received at least 1 course of ICI treatment and were followed up at the medical oncology and pulmonology outpatient clinics were included in the study. The pre-treatment and post-treatment thoracic computed tomography scans taken within 2-24 months were evaluated in collaboration with a thoracic radiologist, and patterns consistent with pneumonitis were identified according to the diagnostic and staging criteria of current guidelines. Patients' medical records and laboratory findings were retrospectively reviewed; patients with respiratory symptoms, elevated C-reactive protein and sedimentation levels, but normal leukocyte levels, were considered consistent with ICI-related pneumonitis. Pneumonitis frequency and potential risk factors were analyzed. Results: Seventy-seven (65.8%) patients were male, and 40 (34.2%) were female, with a mean age of 57.2 years. The overall frequency of ICI-related pneumonitis was found to be 12.8%, while the frequency of high-grade pneumonitis (grade ≥3) was 1.7%. The most common pneumonitis was observed after nivolumab and ipilimumab combination therapy (60% of cases). Pneumonitis of all grades developed on average 5 (range 2-9) months after treatment initiation. Conclusion: Previous lung disease, prior thoracic radiotherapy, and nivolumab+ipilimumab combination therapy emerged as risk factors for the development of ICI-related pneumonitis. Identifying patients at risk for pneumonitis early in clinical practice is crucial to preventing possible complications.
Kangül et al. (Thu,) studied this question.