Knowledge Gaps and Research Priorities in Immune Checkpoint Inhibitor-related Pneumonitis. An Official American Thoracic Society Research Statement

Am J Respir Crit Care Med. 2019 Sep 15;200(6):e31-e43. doi: 10.1164/rccm.201906-1202ST.

Abstract

Rationale: Immune checkpoint inhibitors (ICIs) have revolutionized cancer care but are associated with unique adverse events, including potentially life-threatening pneumonitis. The diagnosis of ICI-pneumonitis is increasing; however, the biological mechanisms, clinical and radiologic features, and the diagnosis and management have not been well defined.Objectives: To summarize evidence, identify knowledge and research gaps, and prioritize topics and propose methods for future research on ICI-pneumonitis.Methods: A multidisciplinary group of international clinical researchers reviewed available data on ICI-pneumonitis to develop and refine research questions pertaining to ICI-pneumonitis.Results: This statement identifies gaps in knowledge and develops potential research questions to further expand knowledge regarding risk, biologic mechanisms, clinical and radiologic presentation, and management of ICI-pneumonitis.Conclusions: Gaps in knowledge of the basic biological mechanisms of ICI-pneumonitis, coupled with a precipitous increase in the use of ICIs alone or combined with other therapies, highlight the importance in triaging research priorities for ICI-pneumonitis.

Keywords: NSCLC; immunotherapy; interstitial lung disease; lung cancer.

MeSH terms

  • Biomedical Research
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Carcinoma, Non-Small-Cell Lung / immunology*
  • Genes, cdc / immunology*
  • Humans
  • Immunologic Factors / adverse effects*
  • Immunologic Factors / therapeutic use*
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / immunology*
  • Organizational Objectives
  • Pneumonia / chemically induced*
  • Research Design
  • Risk Factors
  • Societies, Medical
  • United States

Substances

  • Immunologic Factors