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ASCO-SITC 2020: Radiation Recall Pneumonitis and Nivolumab for Lung Cancer

By: Celeste L. Dixon
Posted: Wednesday, February 12, 2020

Radiation recall pneumonitis may be less prominent than other patterns of pneumonitis in patients with non–small cell lung cancer who have had previous thoracic radiation therapy as well as the immune checkpoint inhibitor nivolumab. In a multicenter retrospective study of 669 total patients, Tadasuke Shimokawaji, MD, PhD, of Kanagawa Cancer Center, Yokohama, Japan, and colleagues reported, “All patients recovered from radiation recall pneumonitis with no exacerbation or death, compared to [a] 9.3% [rate] of exacerbation or death in other patterns of pneumonitis.” Of note, the researchers also found better outcomes in patients who experienced radiation recall pneumonitis. These findings were presented at the 2020 American Society of Clinical Oncology–Society for Immunotherapy of Cancer (ASCO-SITC) Clinical Immuno-Oncology Symposium in Orlando (Abstract 88).

In the total cohort, the incidences of all-grade and grade 3 or higher pneumonitis were 8.8% and 6.2%, respectively. Of the 257 patients who had a history of thoracic radiation therapy, 5.4% developed radiation recall pneumonitis, defined as fibrosis or consolidation in the previously radiated field.

Acknowledging that immune checkpoint inhibitors can cause immune-related pneumonitis in patients with lung cancer, Dr. Shimokawaji and co-investigators could nonetheless find no specific significant risk factors for developing radiation recall pneumonitis after nivolumab treatment. Among other potential factors, they evaluated patient age, sex, smoking history, performance status at the start of nivolumab treatment, background lung disease, history of radiation pneumonitis, and total dose and mean lung dose of thoracic radiation therapy.

Disclosure: For full disclosures of the study authors, visit asco.org.



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