Impact of Checkpoint Inhibitor Pneumonitis on Survival in NSCLC Patients Receiving Immune Checkpoint Immunotherapy
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With increasing use of immune checkpoint inhibitors (ICIs) for advanced NSCLC, there is increasing recognition of immune-related adverse events associated with ICI use. We recently reported increased incidence of checkpoint inhibitor pneumonitis (CIP) in ICI-treated NSCLC patients. Since development of immune-related adverse events in other organ systems has been associated with either no change or even improvement in tumor response/cancer outcomes, we sought to better understand the impact of CIP development on overall survival in ICI-treated NSCLC patients. Using baseline and follow-up data collected on a cohort of 205 ICI-treated NSCLC patients, we used a multi-state modeling approach to understand the effect of developing CIP on the risk of death. We observed time-dependent changes in risk of developing and recovery from CIP, with an increased risk of both developing and recovering from CIP in the first year after initiating ICI. We found that developing CIP independently increased the risk of transitioning to death in both adjusted and unadjusted models. In the multivariate model, we found that the increase in mortality associated with CIP was only seen in patients with adenocarcinoma tumor histology. Collectively, these findings suggest that in NSCLC, development of CIP worsens survival in patients receiving immunotherapy.
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Drug-induced lung injury caused by ICIs worsens the prognosis of patients with NSCLC.
“Previous reports have shown that drug‑induced lung injury caused by ICIs worsens the prognosis of patients with NSCLC(30,31).”
From Clinical impact of inflammatory and nutrition index based on metabolic tumor activity in non‑small cell lung cancer treated with immunotherapy. (2024) · cites this paper as [30]
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- Authors
- Suresh, K., Psoter, K. J., Voong, K. R., Shankar, B., Forde, P. M., Ettinger, D. S., Marrone, K. A., Kelly, R. J., Hann, C. L., Levy, B., Feliciano, J. L., Brahmer, J. R., Feller-Kopman, D., Lerner, A. D., Lee, H., Yarmus, L., Hales, R. K., D’Alessio, F., Danoff, S. K., & Naidoo, J.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Suresh, Karthik
- ORCID
- Venue
- Journal of Thoracic Oncology
- Publisher
- Elsevier BV
- Published
- 2019-03
- Volume
- 14
- Issue
- 3
- Pages
- 494-502
- ISSN
- 1556-0864 (ISSN-L)
- OpenAlex
- W2902441602
- Cited by
- 186
- References
- 26
- Citations by year
- 2026: 24 · 2025: 26 · 2024: 36 · 2023: 25 · 2022: 15 · 2021: 22 · 2020: 26 · 2019: 12
- FWCI
- 5.64
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Thoracic Oncology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (K08HL132055)
- National Heart and Lung Institute
- Celgene
- Bristol-Myers Squibb
- AbbVie
- Eli Lilly and Company
- Lung Cancer Research Foundation
- Genentech
- Takeda Pharmaceuticals U.S.A.
- Bloomberg~Kimmel Institute for Cancer Immunotherapy, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University
- American Society of Clinical Oncology
- Novartis
- Topics
- Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Treatments and Mutations
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
- Keywords
- immune checkpoint inhibitor pneumonitis, non-small cell lung cancer, immune-related adverse events, immune checkpoint inhibitors, overall survival, mortality risk, adenocarcinoma, multi-state models
- MeSH terms
- Antineoplastic Agents, Immunological, Adenocarcinoma of Lung, Aged, Carcinoma, Non-Small-Cell Lung, Carcinoma, Squamous Cell, Female, Follow-Up Studies, Humans, Immunotherapy, Lung Neoplasms, Male, Maryland, Pneumonia, Prognosis, Retrospective Studies, Incidence, Survival Rate, Cell Cycle Checkpoints
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