Immune Checkpoint Inhibitor-Associated Pneumonitis in Patients Treated for Metastatic Renal Cell Carcinoma

Abstract

Simple Summary Immunotherapy has improved outcomes for many people with metastatic kidney cancer, but it can cause inflammation of the lungs, known as pneumonitis. This complication can be difficult to distinguish from infection, cancer progression, or prior radiation-related lung injury and can sometimes be life-threatening. We retrospectively reviewed 146 patients with metastatic kidney cancer treated with immunotherapy at a single academic institution. Pneumonitis occurred in 13 (8.9%) of these patients. It was observed more often among patients who had previously received radiation to the lung or mediastinum, but this study could not account for other factors, so this observation needs confirmation. Most patients improved with treatment. Pneumonitis was severe in more than half of affected patients, and two patients died, although both first presented with mild or moderate pneumonitis. Five patients restarted immunotherapy after recovery without recurrent pneumonitis. These findings support close monitoring for respiratory symptoms during and after immunotherapy.