March 16, 2021
Pneumonitis is a risk after treatment
- Patients who receive durvalumab (brand name: Imfinzi) after chemoradiation should be monitored for potential adverse events
- About 34% of patients who receive this treatment will develop pneumonitis
- Use of long-term steroids can prevent pneumonitis complications
Durvalumab (brand name: Imfinzi) is the standard of care following chemoradiation for patients with stage III unresectable lung cancer. Patients who receive this and other checkpoint inhibitors will need careful monitoring for potential adverse immune events.
“The most feared one in the post-chemoradiation setting is pneumonitis,” says Dr. Balazs Halmos, medical oncologist and director of the Thoracic Oncology Program at Montefiore Medical Center.
In the landmark PACIFIC study, the incidence of any grade pneumonitis in patients receiving Imfinzi was just under 34%, and the incidence of grade 3 or 4 pneumonitis was 3.4%. “The risk of pneumonitis is really not that high,” Dr. Halmos says. “But when it happens, we do not want to miss it. And we do not want to mistreat it.”
He recommends early imaging and evaluation of patients who have received checkpoint inhibitors. Patients with significant pneumonitis can benefit from staying on steroids for a prolonged period of time. “Stopping too early will lead to rebound and significant complications,” he adds.