open access

Vol 14, No 1 (2018)
Review paper
Published online: 2018-02-28
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Management of nivolumab-induced pulmonary toxicity — pneumonitis

Magdalena Knetki-Wróblewska1, Dariusz M. Kowalski
DOI: 10.5603/OCP.2018.0001
·
Oncol Clin Pract 2018;14(1):35-39.


Affiliations

  1. Klinika Nowotworów Płuca i Klatki Piersiowej Centrum Onkologii — Instytut im. Marii Skłodowskiej-Curie

open access

Vol 14, No 1 (2018)
REVIEW ARTICLES
Published online: 2018-02-28

Abstract

Immune-mediated pneumonitis is an uncommon but potentially life-threatening toxicity of nivolumab. The incidence  of pneumonitis is < 10%, but may be higher when nivolumab is combined with other agents. In most cases pneumonitis  is recognised in the first weeks of treatment. Dry cough and dyspnoea are the most common signs of this  adverse event. Diagnostic algorithms recommend radiological investigation with a chest computed tomography  scan. In cases of grade 2 or higher pneumonitis, bronchoscopy with BAL is recommended. Management should  be conducted according to the clinical symptoms; corticosteroids and antibiotics are the drugs of choice. In  severe cases, hospitalisation is necessary and other forms of immunosuppression (infliximab, mycophenolate  mofetil) may be considered. 

Abstract

Immune-mediated pneumonitis is an uncommon but potentially life-threatening toxicity of nivolumab. The incidence  of pneumonitis is < 10%, but may be higher when nivolumab is combined with other agents. In most cases pneumonitis  is recognised in the first weeks of treatment. Dry cough and dyspnoea are the most common signs of this  adverse event. Diagnostic algorithms recommend radiological investigation with a chest computed tomography  scan. In cases of grade 2 or higher pneumonitis, bronchoscopy with BAL is recommended. Management should  be conducted according to the clinical symptoms; corticosteroids and antibiotics are the drugs of choice. In  severe cases, hospitalisation is necessary and other forms of immunosuppression (infliximab, mycophenolate  mofetil) may be considered. 

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Keywords

nivolumab, pulmonary toxicity

About this article
Title

Management of nivolumab-induced pulmonary toxicity — pneumonitis

Journal

Oncology in Clinical Practice

Issue

Vol 14, No 1 (2018)

Article type

Review paper

Pages

35-39

Published online

2018-02-28

DOI

10.5603/OCP.2018.0001

Bibliographic record

Oncol Clin Pract 2018;14(1):35-39.

Keywords

nivolumab
pulmonary toxicity

Authors

Magdalena Knetki-Wróblewska
Dariusz M. Kowalski

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