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The Drug-Induced Respiratory Disease Website

Immune checkpoint inhibitors (ICI) - ICI combinatorial Rx

XXIV.ab

Chronic pneumonitis/ILD

Often requires prolonged corticosteroid therapy and/or immunosuppression

Publications

Yuan-Di Wang , Yuan S, Wen C, Ji Z, Xiang B, Wang B, Zhang Z

Immune checkpoint inhibitor-related chronic pneumonitis: a case report and literature review.

Immunotherapy 2023 Oct;15;1117-1123 — 2023 Oct — 1117-1123

Naidoo J, Cottrell TR, Lipson EJ, Forde PM, Illei PB, Yarmus LB, Voong KR, Feller-Kopman D, Lee H, Riemer J, Wang D, Taube JM, Brahmer JR, Lin CT, Danoff SK, D'Alessio FR, Suresh K

Chronic immune checkpoint inhibitor pneumonitis.

Journal for immunotherapy of cancer 2020 Jun;8; — 2020 Jun

Diagnosing DIRD

Drug and radiation history

Drug singularity - Correct identification of the drug

Consistent timing of exposure v. onset of symptoms

Clinical, imaging, BAL, pathological pattern consistent with the specific drug

Careful exlusion of another cause

Remission of symptoms with removal of drug

Recurrence with rechallenge (rarely advisable)

Causality assessment

Diagnosing DIRD

Identify causative drugs

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