Management of nivolumab-induced pulmonary toxicity — pneumonitis
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.
Keywords: nivolumabpulmonary toxicity
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