Navigating the waters of immune checkpoint inhibitor pulmonary toxicity

• DOI: 10.2500/jprm.2025.8.240015
• Publication Date: 2025-03-04T04:31:01Z
• Authors: Rose M. Puthumana; Susan J. Vehar; Abigail L. Koch
• Keywords: Immune checkpoint; Pulmonary toxicity

Background: The use of immune checkpoint inhibitor (ICI) therapy has improved outcomes for many types cancer, including primary lung cancer. With increased this therapy, immune-related adverse events (IRAE) are identified more frequently and can affect any organ system. ICI-pneumonitis varied levels severity at the time diagnosis that range from mild with nonspecific symptoms to fatal respiratory failure in severe cases. Therefore, early recognition is crucial, a multidisciplinary approach recommended diagnosis, treatment, surveillance. Methods: We performed narrative literature review. Results: clinical based on medication exposure, symptoms, radiographic abnormalities, reduced function after carefully ruling out other causes, especially infection. Treatment disease and, higher-grade cases, consists holding ICI course corticosteroids. duration treatment depends initial response careful monitoring recurrence during corticosteroid taper. Re-challenge offending also should be considered case-by-case basis IRAE team when available. Steroid-sparing agents or prolonged tapers may Morbidity mortality highest acute phase, survivors phase often have overall good recovery. Chronic rare, persistent decline, imaging abnormality; management by pulmonologist reasonable. Although some risk factors developing noted, there currently no preventive measures known limit development ICI-pneumonitis, it still unclear who will develop IRAE. Conclusion: Increased awareness an important step toward consistent identification diagnosis. Treatment-related trials cohort studies needed phenotype advance our understanding approach.