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Immune-Related Adverse Events for Lung Toxicity - Pneumonitis
CTCAE-based severity grade for pneumonitis from checkpoint inhibitor therapy.
Immune-Related Adverse Events for Lung Toxicity - Pneumonitis
Clinical picture
ResultNo pneumonitis
No evidence of pneumonitis.
When to use
- Grading pneumonitis in patients on immune checkpoint inhibitor therapy after infection and disease progression have been reasonably excluded.
Formula
CTCAE v5.0 pneumonitis grading: Grade 1, asymptomatic (radiographic findings only); Grade 2, symptomatic, medical intervention indicated; Grade 3, severe symptoms, limiting self-care, oxygen indicated; Grade 4, life-threatening respiratory compromise, urgent intervention (e.g., intubation) indicated.
Pearls and pitfalls
- Pneumonitis is more common with combination checkpoint inhibitor therapy and with prior thoracic radiation.
- Grade >=2 generally warrants holding therapy and starting systemic corticosteroids; grade 3-4 usually means permanent discontinuation.