The American Society of Clinical Oncology (ASCO) has reviewed complications associated with immune checkpoint inhibitor therapy. One complication is pneumonitis.
Patient selection: pneumonitis following therapy with immune checkpoint inhibitor
Parameters:
(1) extent of lung involvement
(2) need for intervention
(3) impact of pulmonary disease
Extent of Lung Involvement
Need for Intervention
Impact
Grade
one lobe of lung OR <25% of lung parenchyma
none
asymptomatic
G1
more than one lobe of lung OR 25-50% of lung parenchyma
medical
limits instrumental ADL
G2
all lobes OR > 50% of lung parenchyma
hospitalization; supplemental oxygen
limits instrumental ADL
G3
all lobes OR > 50% of lung parenchyma
urgent; intubation
life-threatening
G4
Chronic pneumonitis can occur but incidence less than 2%.
Differential diagnosis:
(1) drug toxicity
(2) infectious pneumonitis
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