Pneumonitis is more likely to emerge in patients treated with Programmed cell death 1 (PD-1) inhibitors for non-small cell lung cancer (NSCLC) or renal cell carcinoma versus those being treated for melanoma, a new study claims.
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Though rare, pneumonitis is a serious and potentially life-threating adverse event. Little is known about pneumonitis, but previous studies have shown that it can occur as a result of treatment with PD-1 inhibitors, a new and popular line of cancer drugs. Researchers led by Mizuki Nishino, MD, MPH, Dana-Farber Cancer Center Institute (Boston, MA), compared the incidence of PD-1-related pneumonitis among different tumor types and therapeutic regimens.
After a comprehensive PubMed review, they identified 26 original articles of PD-1 inhibitor treatment for melanoma, NSCLC, or renal cell carcinoma. Twenty were deemed eligible and included in the final analysis and the primary outcome was incidence of all-grade and grade 3 or higher pneumonitis, and pneumonitis-related deaths.
Of 4496 total patients included in the analysis, 2.7% had pneumonitis and .8% had grade 3 or higher pneumonitis. Incidence of pneumonitis was highest in patients with lung cancer, where 4.1% of patients developed the condition, 1.8% of whom had grade 3 or higher severity. Four patients treated only with PD-1 inhibitors died a result of pneumonitis. Incidence of pneumonitis was also 4.1% in patients with kidney cancer, but the proportion of patients with grade 3 or higher condition was significantly lower. In contrast, only 1.6% of patients with melanoma developed any grade pneumonitis, with .2% having grade 3 or higher.
Additionally, researchers found that pneumonitis occurred more frequently with combination regimens than with PD-1 inhibitors alone. In melanoma, incidence of pneumonitis was 6.6% during combination therapy, with 1.5% of patients experiencing grade 3 or higher severity and 1 patient dying from the condition.
Thus, researchers concluded that incidence of PD-1 inhibitor-related pneumonitis was higher in patients with NSCLC and renal cell carcinoma than melanoma. They added that combination therapy with PD-1 inhibitors and another drug type may increase the incidence of pneumonitis.
