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Immune-checkpoint inhibitors associated with interstitial lung disease in cancer patients.

  • Delaunay M Service de Pneumologie, Hôpital Larrey, Centre Hospitalier Universitaire, Université Paul Sabatier, Toulouse, France.
  • Cadranel J Service de Pneumologie, APHP Hôpital Tenon and Sorbonne Universités, UPMC Univ Paris 06, Paris, France.
  • Lusque A Cellule Biostatistique, Bureau des Essais Cliniques, Institut Claudius Regaud, IUCT-O, Toulouse, France.
  • Meyer N Service de Dermatologie, IUCT, Centre Hospitalier Universitaire, Université Paul Sabatier, Toulouse, France.
  • Gounant V Service d'Oncologie Thoracique, University Hospital Bichat, APHP, Paris, France.
  • Moro-Sibilot D Department of Thoracic Oncology, Centre Hospitalier Universitaire, Grenoble, France.
  • Michot JM Hematological Malignancies and Drug Development Departments, Gustave Roussy, Cancer Campus Grand Paris, Villejuif, France.
  • Raimbourg J Service d'Oncologie Médicale, Institut de Cancérologie de l'Ouest, St Herblain, Inserm U892, Nantes, France.
  • Girard N Service de Pneumologie, Institut de Cancérologie des Hospices Civils de Lyon, Lyon, France.
  • Guisier F Service de Pneumologie, Oncologie Thoracique et Soins Intensifs Respiratoires, Rouen University, Hopital, CIC INSERM 1404, Quant IF-LITIS, Rouen, France.
  • Planchard D Medical Oncology Department, Gustave Roussy Cancer Center, Villejuif, France.
  • Metivier AC Service de Pneumologie, Hôpital Foch, Suresne, France.
  • Tomasini P Multidisciplinary Oncology and Therapeutic Innovations Dept, Aix Marseille University, Assistance Publique Hôpitaux de Marseille, Marseille, France.
  • Dansin E Département de Cancérologie Générale, Centre Oscar Lambret, Lille, France.
  • Pérol M Département de Cancérologie Médicale, Centre Léon Bérard, Lyon, France.
  • Campana M Service de Pneumologie, CHRU Tours, Tours, France.
  • Gautschi O Medical Oncology Department, Lucerne Cantonal Hospital, Luzern, Switzerland.
  • Früh M Medical Oncology Department, Kantonsspital St Gallen, St Gallen, Switzerland.
  • Fumet JD Département Oncologie Medicale, Centre Georges-Francois Leclerc, Dijon, France.
  • Audigier-Valette C Service de Pneumonologie, Hôpital Saint Musse, Toulon, France.
  • Couraud S Service de Pneumologie Aiguë Spécialisée et Cancérologie Thoracique, Hospices Civils de Lyon, Université Claude Bernard, Lyon, France.
  • Dalle S Service de Pneumologie Aiguë Spécialisée et Cancérologie Thoracique, Hospices Civils de Lyon, Université Claude Bernard, Lyon, France.
  • Leccia MT Service de Dermatologie, Hospices Civils de Lyon, Université Claude Bernard, Lyon, France.
  • Jaffro M Service de Dermatologie, CHU de Grenoble site Nord - Hôpital Albert Michallon, Grenoble, France.
  • Collot S Service de Dermatologie, CHU de Grenoble site Nord - Hôpital Albert Michallon, Grenoble, France.
  • Prévot G Service de Pneumologie, Hôpital Larrey, Centre Hospitalier Universitaire, Université Paul Sabatier, Toulouse, France.
  • Milia J Service de Pneumologie, Hôpital Larrey, Centre Hospitalier Universitaire, Université Paul Sabatier, Toulouse, France.
  • Mazieres J Service de Pneumologie, Hôpital Larrey, Centre Hospitalier Universitaire, Université Paul Sabatier, Toulouse, France mazieres.j@chu-toulouse.fr.
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  • 2017-08-12
Published in:
  • The European respiratory journal. - 2017
Adult
Aged
Aged, 80 and over
Female
France
Humans
Immunotherapy
Kaplan-Meier Estimate
Lung
Lung Diseases, Interstitial
Male
Middle Aged
Neoplasms
Programmed Cell Death 1 Receptor
Retrospective Studies
Risk Factors
Severity of Illness Index
Switzerland
Tomography, X-Ray Computed
Young Adult
English Immunotherapy is becoming a standard of care for many cancers. Immune-checkpoint inhibitors (ICI) can generate immune-related adverse events. Interstitial lung disease (ILD) has been identified as a rare but potentially severe event.Between December 2015 and April 2016, we conducted a retrospective study in centres experienced in ICI use. We report the main features of ICI-ILD with a focus on clinical presentation, radiological patterns and therapeutic strategies.We identified 64 (3.5%) out of 1826 cancer patients with ICI-ILD. Patients mainly received programmed cell death-1 inhibitors. ILD usually occurred in males, and former or current smokers, with a median age of 59 years. We observed 65.6% grade 2/3 severity, 9.4% grade 4 severity and 9.4% fatal ILD. The median (range) time from initiation of immunotherapy to ILD was 2.3 (0.2-27.4) months. Onset tended to occur earlier in lung cancer versus melanoma: median 2.1 and 5.2 months, respectively (p=0.02). Ground-glass opacities (81.3%) were the predominant lesions, followed by consolidations (53.1%). Organising pneumonia (23.4%) and hypersensitivity pneumonitis (15.6%) were the most common patterns. Overall survival at 6 months was 58.1% (95% CI 37.7-73.8%).ICI-ILD often occurs early and displays suggestive radiological features. As there is no clearly identified risk factor, oncologists need to diagnose and adequately treat this adverse event.
Language
  • English
Open access status
bronze
Identifiers
Persistent URL
https://sonar.ch/global/documents/186477
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