PMID- 35399572 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220413 IS - 2218-6751 (Print) IS - 2226-4477 (Electronic) IS - 2218-6751 (Linking) VI - 11 IP - 3 DP - 2022 Mar TI - Rate and risk factors of recurrent immune checkpoint inhibitor-related pneumonitis in patients with lung cancer. PG - 381-392 LID - 10.21037/tlcr-22-168 [doi] AB - 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 radiotherapy (P=0.049). The duration of prednisolone equivalent dose >/=15 mg/day in CIP-R was significantly shorter, at 3.71 weeks (2.86-6.57 weeks) compared with 6.36 weeks in those without recurrence (IQR, 3.12-9.86 weeks) (P=0.001). Non-squamous histology [odds ratio (OR), 0.182; 95% confidence interval (CI): 0.038-0.860; P=0.031] and prolonged administration of prednisolone equivalent dose >/=15 mg/day for more than 4 weeks (OR, 0.082; 95% CI: 0.02-0.342; P=0.001) were independently associated with a decreased odds of CIP-R development. CONCLUSIONS: CIP-R in a real-world lung cancer cohort is not uncommon, both in patients with and without rechallenge of ICIs. A duration of prednisolone equivalent dose >/=15 mg/day of at least 4 weeks during the tapering process of corticosteroids were recommend in patients with CIP. CI - 2022 Translational Lung Cancer Research. All rights reserved. FAU - Tao, Haitao AU - Tao H AD - Senior Department of Oncology, the Fifth Medical Center of Chinese PLA General Hospital, Beijing, China. FAU - Li, Fangfang AU - Li F AD - Department of State Guest, Institute of Health Management, the Second Medical Center of Chinese PLA General Hospital, Beijing, China. FAU - Wu, Dongxiao AU - Wu D AD - Department of Oncology, the First Medical Center of Chinese PLA General Hospital, Beijing, China. FAU - Ji, Shiyu AU - Ji S AD - Senior Department of Oncology, the Fifth Medical Center of Chinese PLA General Hospital, Beijing, China. FAU - Liu, Qingyan AU - Liu Q AD - Senior Department of Oncology, the Fifth Medical Center of Chinese PLA General Hospital, Beijing, China. FAU - Wang, Lijie AU - Wang L AD - Senior Department of Oncology, the Fifth Medical Center of Chinese PLA General Hospital, Beijing, China. FAU - Liu, Bo AU - Liu B AD - Department of Radiology, the First Medical Center of Chinese PLA General Hospital, Beijing, China. FAU - Facchinetti, Francesco AU - Facchinetti F AD - Universite Paris-Saclay, Institut Gustave Roussy, Inserm, Biomarqueurs Predictifs et Nouvelles, Strategies Therapeutiques en Oncologie, Villejuif, France. FAU - Leong, Tracy L AU - Leong TL AD - Department of Respiratory Medicine, Austin Health, Heidelberg, Victoria, Australia. FAU - Passiglia, Francesco AU - Passiglia F AD - Department of Oncology, University of Turin, San Luigi Gonzaga Hospital, Orbassano (TO), Italy. FAU - Hu, Yi AU - Hu Y AD - Senior Department of Oncology, the Fifth Medical Center of Chinese PLA General Hospital, Beijing, China. LA - eng PT - Journal Article PL - China TA - Transl Lung Cancer Res JT - Translational lung cancer research JID - 101646875 PMC - PMC8988083 OTO - NOTNLM OT - ICIs-related adverse event (irAE) OT - Lung cancer OT - immune checkpoint inhibitors (ICIs) OT - recurrent pneumonitis COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tlcr.amegroups.com/article/view/10.21037/tlcr-22-168/coif). FF received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from BMS, Roche and BeiGene. FP declared consulting/advisory board fee from Astrazeneca, Janssen, Amgen, Termofisher Scientific, Beigene, and Sanofi. The other authors have no conflicts of interest to declare. EDAT- 2022/04/12 06:00 MHDA- 2022/04/12 06:01 PMCR- 2022/03/01 CRDT- 2022/04/11 05:14 PHST- 2021/11/30 00:00 [received] PHST- 2022/03/18 00:00 [accepted] PHST- 2022/04/11 05:14 [entrez] PHST- 2022/04/12 06:00 [pubmed] PHST- 2022/04/12 06:01 [medline] PHST- 2022/03/01 00:00 [pmc-release] AID - tlcr-11-03-381 [pii] AID - 10.21037/tlcr-22-168 [doi] PST - ppublish SO - Transl Lung Cancer Res. 2022 Mar;11(3):381-392. doi: 10.21037/tlcr-22-168.