Immune-checkpoint inhibitors associated with interstitial lung disease in cancer patients.
Fiche publication
Date publication
août 2017
Journal
The European respiratory journal
Auteurs
Membres identifiés du Cancéropôle Est :
Dr FUMET Jean-David
Tous les auteurs :
Delaunay M, Cadranel J, Lusque A, Meyer N, Gounant V, Moro-Sibilot D, Michot JM, Raimbourg J, Girard N, Guisier F, Planchard D, Metivier AC, Tomasini P, Dansin E, Pérol M, Campana M, Gautschi O, Früh M, Fumet JD, Audigier-Valette C, Couraud S, Dalle S, Leccia MT, Jaffro M, Collot S, Prévot G, Milia J, Mazieres J
Lien Pubmed
Résumé
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 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.
Mots clés
Adult, Aged, Aged, 80 and over, Female, France, Humans, Immunotherapy, adverse effects, Kaplan-Meier Estimate, Lung, diagnostic imaging, Lung Diseases, Interstitial, diagnostic imaging, Male, Middle Aged, Neoplasms, therapy, Programmed Cell Death 1 Receptor, antagonists & inhibitors, Retrospective Studies, Risk Factors, Severity of Illness Index, Switzerland, Tomography, X-Ray Computed, Young Adult
Référence
Eur. Respir. J.. 2017 08;50(2):