ABSTRACT Checkpoint inhibitor pneumonitis (CIP) is an immune‐related adverse event that can occur after initiation of anti–programmed death 1/programmed death ligand 1 immune checkpoint inhibitor (ICI) therapy for the treatment of multiple malignancies, including NSCLC. However, the incidence of CIP has not been previously examined in a population that included both trial‐enrolled and non–trial‐enrolled patients with advanced NSCLC. Furthermore, risk factors and other clinical characteristics associated with CIP severity are not known. In this study, we retrospectively examined clinical characteristics, incidence, and risk factors for CIP in a cohort of 205 patients with NSCLC, all of whom received anti–programmed death 1/programmed death ligand 1 ICIs. Our results demonstrate a higher incidence of CIP (19%) than previously reported in clinical trials (3%–5%). Our data also suggest that tumor histologic type may be a risk factor for CIP development. We observed a wide range of time to onset of CIP (median 82 days), with high morbidity and mortality associated with higher‐grade CIP regardless of degree of immunosuppression. Our data provide new insight into the epidemiology and clinical characteristics of CIP. Further studies are needed to increase CIP pharmacovigilance, improve risk stratification, and refine diagnostic algorithms for the diagnosis and management of this potential life‐threatening complication of ICI therapy.

中文翻译：

---

接受免疫检查点免疫疗法的非小细胞肺癌患者的肺炎：发病率和危险因素

摘要 检查点抑制剂肺炎 (CIP) 是一种免疫相关的不良事件，可在抗程序性死亡 1/程序性死亡配体 1 免疫检查点抑制剂 (ICI) 治疗开始后发生，用于治疗多种恶性肿瘤，包括 NSCLC。然而，之前尚未在包括试验登记和非试验登记的晚期 NSCLC 患者的人群中检查 CIP 的发生率。此外，与 CIP 严重程度相关的风险因素和其他临床特征尚不清楚。在本研究中，我们回顾性研究了 205 名 NSCLC 患者队列中 CIP 的临床特征、发病率和危险因素，所有患者均接受了抗程序性死亡 1/程序性死亡配体 1 ICI。我们的结果表明，CIP 的发生率 (19%) 比之前在临床试验中报告的 (3%–5%) 更高。我们的数据还表明，肿瘤组织学类型可能是 CIP 发展的危险因素。我们观察到 CIP 发生的时间范围很广（中位 82 天），无论免疫抑制程度如何，高级别 CIP 的发病率和死亡率都很高。我们的数据为 CIP 的流行病学和临床特征提供了新的见解。需要进一步的研究来提高 CIP 药物警戒，改善风险分层，并完善诊断和管理 ICI 治疗潜在危及生命并发症的诊断算法。无论免疫抑制程度如何，高级别 CIP 的发病率和死亡率都很高。我们的数据为 CIP 的流行病学和临床特征提供了新的见解。需要进一步的研究来提高 CIP 药物警戒，改善风险分层，并完善诊断和管理 ICI 治疗潜在危及生命并发症的诊断算法。无论免疫抑制程度如何，高级别 CIP 的发病率和死亡率都很高。我们的数据为 CIP 的流行病学和临床特征提供了新的见解。需要进一步的研究来提高 CIP 药物警戒，改善风险分层，并完善诊断和管理 ICI 治疗潜在危及生命并发症的诊断算法。