Chinese expert consensus on the multidisciplinary management of pneumonitis associated with immune checkpoint inhibitor

Wenxian Wang; Qian Wang; Chunwei Xu; Ziming Li; Zhengbo Song; Yongchang Zhang; Xiuyu Cai; Shirong Zhang; Bin Lian; Wen Li; Anwen Liu; Ping Zhan; Hongbing Liu; Tangfeng Lv; Liyun Miao; Lingfeng Min; Yu Chen; Jingping Yuan; Feng Wang; Zhansheng Jiang; Gen Lin; Xingxiang Pu; Chuangzhou Rao; Dongqing Lv; Zongyang Yu; Xiaoyan Li; Chuanhao Tang; Chengzhi Zhou; Congying Xie; Junping Zhang; Hui Guo; Qian Chu; Rui Meng; Jingxun Wu; Rui Zhang; Liping Wang; Youcai Zhu; Xiao Hu; Yanru Xie; Xinqing Lin; Jing Cai; Fen Lan; Huijing Feng; Lin Wang; Wang Yao; Xuefei Shi; Jianhui Huang; Huafei Chen; Yinbin Zhang; Pingli Sun; Bing Wan; Fei Pang; Zanmei Xu; Kai Wang; Yuanli Xia; Mingxiang Ye; Dong Wang; Qing Wei; Shuitu Feng; Jianya Zhou; Jiexia Zhang; Donglai Lv; Wenbin Gao; Jing Kang; Genhua Yu; Xianbin Liang; Chengtao Yu; Lin Shi; Nong Yang; Lin Wu; Zhuan Hong; Wei Hong; Meiyu Fang; Yiping Zhang; Yuanzhi Lu; Guansong Wang; Shenglin Ma; Lu Si; Wenfeng Fang; Yong Song

doi:10.1111/1759-7714.14693

Chinese expert consensus on the multidisciplinary management of pneumonitis associated with immune checkpoint inhibitor

Thorac Cancer. 2022 Dec;13(23):3420-3430. doi: 10.1111/1759-7714.14693. Epub 2022 Oct 21.

Authors

Wenxian Wang¹, Qian Wang², Chunwei Xu^{3

4}, Ziming Li⁵, Zhengbo Song¹, Yongchang Zhang⁶, Xiuyu Cai⁷, Shirong Zhang⁸, Bin Lian⁹, Wen Li¹⁰, Anwen Liu¹¹, Ping Zhan⁴, Hongbing Liu⁴, Tangfeng Lv⁴, Liyun Miao¹², Lingfeng Min¹³, Yu Chen¹⁴, Jingping Yuan¹⁵, Feng Wang¹⁶, Zhansheng Jiang¹⁷, Gen Lin¹⁴, Xingxiang Pu¹⁸, Chuangzhou Rao¹⁹, Dongqing Lv²⁰, Zongyang Yu²¹, Xiaoyan Li²², Chuanhao Tang²³, Chengzhi Zhou²⁴, Congying Xie²⁵, Junping Zhang²⁶, Hui Guo²⁷, Qian Chu²⁸, Rui Meng²⁹, Jingxun Wu³⁰, Rui Zhang³¹, Liping Wang³², Youcai Zhu³³, Xiao Hu³⁴, Yanru Xie³⁵, Xinqing Lin²⁴, Jing Cai¹¹, Fen Lan¹⁰, Huijing Feng²⁶, Lin Wang³⁶, Wang Yao³⁷, Xuefei Shi³⁸, Jianhui Huang³⁵, Huafei Chen³³, Yinbin Zhang³⁹, Pingli Sun⁴⁰, Bing Wan⁴¹, Fei Pang⁴², Zanmei Xu⁴², Kai Wang⁴², Yuanli Xia⁴³, Mingxiang Ye⁴, Dong Wang⁴, Qing Wei¹, Shuitu Feng⁴⁴, Jianya Zhou⁴⁵, Jiexia Zhang²⁴, Donglai Lv⁴⁶, Wenbin Gao⁴⁷, Jing Kang⁴⁸, Genhua Yu⁴⁹, Xianbin Liang⁵⁰, Chengtao Yu⁵¹, Lin Shi⁵², Nong Yang⁶, Lin Wu¹⁸, Zhuan Hong⁵³, Wei Hong¹, Meiyu Fang¹, Yiping Zhang¹, Yuanzhi Lu⁵⁴, Guansong Wang⁵⁵, Shenglin Ma⁵⁶, Lu Si⁹, Wenfeng Fang⁵⁷, Yong Song⁴

Affiliations

¹ Department of Chemotherapy, Chinese Academy of Sciences University Cancer Hospital (Zhejiang Cancer Hospital), Hangzhou, China.
² Department of Respiratory Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China.
³ Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Hangzhou, China.
⁴ Department of Respiratory Medicine, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
⁵ Department of Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.
⁶ Department of Medical Oncology, Lung Cancer and Gastrointestinal Unit, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
⁷ Department of VIP Inpatient, Sun Yet-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
⁸ Translational Medicine Research Center, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Affiliated Hangzhou First People's Hospital, Cancer Center, Zhejiang University School of Medicine, Hangzhou, China.
⁹ Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Melanoma and Sarcoma, Peking University Cancer Hospital and Institute, Beijing, China.
¹⁰ Key Laboratory of Respiratory Disease of Zhejiang Province, Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Cancer Center, Zhejiang University, Hangzhou, China.
¹¹ Department of Oncology, Second Affiliated Hospital of Nanchang University, Nanchang, China.
¹² Department of Respiratory Medicine, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.
¹³ Department of Respiratory Medicine, Clinical Medical School of Yangzhou University, Subei People's Hospital of Jiangsu Province, Yangzhou, China.
¹⁴ Department of Medical Oncology, Fujian Medical University Cancer Hospital and Fujian Cancer Hospital, Fuzhou, China.
¹⁵ Department of Pathology, Renmin Hospital of Wuhan University, Wuhan, China.
¹⁶ Department of Internal Medicine, Cancer Center of PLA, Qinhuai Medical Area, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
¹⁷ Derpartment of Integrative Oncology, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
¹⁸ Department of Medical Oncology, Lung Cancer, and Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
¹⁹ Department of Radiotherapy and Chemotherapy, Hwamei Hospital, University of Chinese Academy of Sciences, Ningbo, China.
²⁰ Department of Pulmonary Medicine, Taizhou Hospital of Wenzhou Medical University, Taizhou, China.
²¹ Department of Respiratory Medicine, The 900th Hospital of the Joint Logistics Team (The Former Fuzhou General Hospital), Fujian Medical University, Fuzhou, China.
²² Department of Oncology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
²³ Department of Medical Oncology, Peking University International Hospital, Beijing, China.
²⁴ State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University (The First Affiliated Hospital of Guangzhou Medical University), Guangzhou, China.
²⁵ Department of Radiation Oncology, First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China.
²⁶ Department of Thoracic Oncology, Shanxi Academy of Medical Sciences, Shanxi Bethune Hospital, Taiyuan, China.
²⁷ Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
²⁸ Department of Oncology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
²⁹ Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
³⁰ Department of Medical Oncology, The First Affiliated Hospital of Medicine, Xiamen University, Xiamen, China.
³¹ Department of Medical Oncology, Cancer Hospital of China Medical University, Shenyang, China.
³² Department of Oncology, Baotou Cancer Hospital, Baotou, China.
³³ Department of Thoracic Disease Diagnosis and Treatment Center, Zhejiang Rongjun Hospital, The Third Affiliated Hospital of Jiaxing University, Jiaxing, China.
³⁴ Zhejiang Key Laboratory of Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China.
³⁵ Department of Oncology, Lishui Municipal Central Hospital, Lishui, China.
³⁶ Department of Pathology, Shanxi Academy of Medical Sciences, Shanxi Bethune Hospital, Taiyuan, China.
³⁷ Department of Interventional Oncology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
³⁸ Department of Respiratory Medicine, Huzhou Hospital, Zhejiang University School of Medicine, Huzhou, China.
³⁹ Department of Oncology, The Second Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, China.
⁴⁰ Department of Pathology, The Second Hospital of Jilin University, Changchun, China.
⁴¹ Department of Respiratory Medicine, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China.
⁴² Department of Medical, Shanghai OrigiMed Co. Ltd, Shanghai, China.
⁴³ Department of Medical Affairs, AstraZeneca China, Shanghai, China.
⁴⁴ Department of Oncology, Xiamen Haicang Hospital, Xiamen, China.
⁴⁵ Department of Respiratory Disease, Thoracic Disease Center, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
⁴⁶ Department of Clinical Oncology, The 901 Hospital of Joint Logistics Support Force of People Liberation Army, Hefei, China.
⁴⁷ Department of Oncology, The Third Affiliated Hospital of Shenzhen University, Shenzhen, China.
⁴⁸ Guangdong Lung Cancer Institute, Guangdong Provincial Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, School of Medicine, Guangzhou, China.
⁴⁹ Department of Radiation Oncology, Zhebei Mingzhou Hospital, Huzhou, China.
⁵⁰ Department of Oncology, The Third People's Hospital of Zhengzhou, Zhengzhou, China.
⁵¹ Collaborative Innovation Center of Jiangsu Province of Cancer Prevention and Treatment of Chinese Medicine, Nanjing, China.
⁵² Department of Respiratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
⁵³ Department of Medical Oncology, Jiangsu Cancer Hospital, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China.
⁵⁴ Department of Clinical Pathology, The First Affiliated Hospital of Jinan University, Guangzhou, China.
⁵⁵ Institute of Respiratory Diseases, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
⁵⁶ Department of Oncology, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Affiliated Hangzhou Cancer Hospital, Cancer Center, Zhejiang University School of Medicine, Hangzhou, China.
⁵⁷ Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.

Abstract

Immune checkpoint inhibitors (ICIs) have successfully treated a number of different types of cancer, which is of great significance for cancer treatment. With the widespread use of ICIs in clinical practice, the increasing checkpoint inhibitor pneumonia (CIP) will be a challenge to clinicians. To guide the diagnosis and treatment of CIP, we conducted in-depth discussions based on the latest evidence, forming a consensus among Chinese experts on the multidisciplinary management of CIP.

Trial registration: ClinicalTrials.gov NCT05338619.

Keywords: Chinese experts consensus; checkpoint inhibitor pneumonitis; immune checkpoint inhibitor-related adverse effects.

MeSH terms

Antineoplastic Agents, Immunological* / therapeutic use
China
Consensus
Humans
Immune Checkpoint Inhibitors / adverse effects
Lung Neoplasms* / drug therapy
Pneumonia* / chemically induced
Pneumonia* / diagnosis
Pneumonia* / drug therapy

Substances

Immune Checkpoint Inhibitors
Antineoplastic Agents, Immunological

Associated data

ClinicalTrials.gov/NCT05338619