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.

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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