Proposed clinical phases for the improvement of personalized treatment of checkpoint inhibitor–related pneumonitis

• DOI: 10.3389/fimmu.2022.935779
• Publication Date: 2022-07-27T14:27:53Z
• Authors: Chengzhi Zhou; Yilin Yang; Xinqing Lin; Nianxin Fang; Likun Chen; Juhong Jiang; Haiyi Deng; Yu Deng; Minghui Wan; Guihuan Qiu; Ni Sun; Di Wu; Xiang Long; Changhao Zhong; Xiaohong Xie; Zhanhong Xie; Ming Liu; Ming Ouyang; Yinyin Qin; Francesco Petrella; Alfonso Fiorelli; Sara Bravaccini; Yuki Kataoka; Satoshi Watanabe; Taichiro Goto; Piergiorgio Solli; Hitoshi Igai; Yuichi Saito; Nikolaos Tsoukalas; Takeo Nakada; Shiyue Li; Rongchang Chen
• Keywords: Pneumonitis

Checkpoint inhibitor-related pneumonitis (CIP) is a lethal immune-related adverse event. However, the development process of CIP, which may provide insight into more effective management, has not been extensively examined. We conducted multicenter retrospective analysis 56 patients who developed CIP. Clinical characteristics, radiological features, histologic and laboratory tests were analyzed. After comprehensive analysis, we proposed acute, subacute, chronic phases CIP summarized each phase's characteristics. There 51 in acute phase, 22 subacute 11 phase. The median interval time from beginning to different was calculated (acute phase: ≤4.9 weeks; 4.9~13.1 ≥13.1 weeks). symptoms relieved phase grade Performance Status score decreased (P<0.05). main change radiologic features absorption lesions, 3 (3/11) had persistent traction bronchiectasis. For most fibrinous (5/8), organizing pneumonia (5/6). Other changes advanced over time, with lesions entering state fibrosis. Moreover, levels interleukin-6, interleukin-10 high-sensitivity C-reactive protein (hsCRP) increased as progressed (IL-6: 17.9 vs. 9.8 5.7, P=0.018; IL-10: 4.6 vs 3.0 2.0, P=0.041; hsCRP: 88.2 19.4 14.4, P=0.005). general can be divided phases, upon better management strategy might based devised.