Mark Hammer1, Stephen Bagley2, Charu Aggarwal2, Joshua Bauml2, Arun C Nachiappan3, Charles B Simone4, Corey Langer2, Sharyn I Katz5. 1. Department of Radiology, Brigham and Women's Hospital, Boston, MA; Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA. 2. Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA. 3. Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA. 4. Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD. 5. Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA. Electronic address: sharyn.katz@uphs.upenn.edu.
Abstract
PURPOSE: Treatment with anti-programmed death receptor-1 (PD-1) therapeutics can lead to unconventional responses and side effect profiles due to their potentiating effects on the immune system. Here we evaluate the radiologic manifestations of anti-PD-1 therapy in the chest in patients with non-small cell lung cancer (NSCLC) receiving anti-PD-1 therapy. MATERIALS AND METHODS: A retrospective review of real-world clinical practice was conducted of all the patients with NSCLC receiving anti-PD-1 therapy at our institution between 2013 and 2016. All patients without adequate clinical or radiologic follow-up data in the electronic medical records were excluded. Imaging examinations for all patients deemed by their thoracic oncologists to have radiologic pseudoprogression or therapy-associated pneumonitis were reviewed by experienced thoracic radiologists. RESULTS: A total of 166 patients with NSCLC had available clinical and imaging data for retrospective review. Of these patients, 4 (2%) were considered to have radiologic pseudoprogression, 3 of which manifested as increased tumor size and 1 of which manifested with new lesions. A total of 5 patients (3%) were clinically deemed to have pneumonitis attributable to anti-PD-1 therapy, 4 of which had radiologic manifestations on computed tomography. CONCLUSION: Radiologic pseudoprogression and drug-induced pneumonitis are uncommon but important manifestations of anti-PD-1 therapy on thoracic imaging.
PURPOSE: Treatment with anti-programmed death receptor-1 (PD-1) therapeutics can lead to unconventional responses and side effect profiles due to their potentiating effects on the immune system. Here we evaluate the radiologic manifestations of anti-PD-1 therapy in the chest in patients with non-small cell lung cancer (NSCLC) receiving anti-PD-1 therapy. MATERIALS AND METHODS: A retrospective review of real-world clinical practice was conducted of all the patients with NSCLC receiving anti-PD-1 therapy at our institution between 2013 and 2016. All patients without adequate clinical or radiologic follow-up data in the electronic medical records were excluded. Imaging examinations for all patients deemed by their thoracic oncologists to have radiologic pseudoprogression or therapy-associated pneumonitis were reviewed by experienced thoracic radiologists. RESULTS: A total of 166 patients with NSCLC had available clinical and imaging data for retrospective review. Of these patients, 4 (2%) were considered to have radiologic pseudoprogression, 3 of which manifested as increased tumor size and 1 of which manifested with new lesions. A total of 5 patients (3%) were clinically deemed to have pneumonitis attributable to anti-PD-1 therapy, 4 of which had radiologic manifestations on computed tomography. CONCLUSION: Radiologic pseudoprogression and drug-induced pneumonitis are uncommon but important manifestations of anti-PD-1 therapy on thoracic imaging.
Authors: O Humbert; N Cadour; M Paquet; R Schiappa; M Poudenx; D Chardin; D Borchiellini; D Benisvy; M J Ouvrier; C Zwarthoed; A Schiazza; M Ilie; H Ghalloussi; P M Koulibaly; J Darcourt; J Otto Journal: Eur J Nucl Med Mol Imaging Date: 2019-11-23 Impact factor: 9.236
Authors: Eun Young Kim; Inkeun Park; Young Saing Kim; Hee Kyung Ahn; Hee Young Lee; Jeong Ho Kim Journal: Thorac Cancer Date: 2019-02-07 Impact factor: 3.500