Chest bump.

We know toxicity rates following thoracic radiation in people with certain autoimmune disorders like interstitial lung disease are scary. So how might a history of unleashing the immune system with immune checkpoint inhibitors (ICI) affect adverse events with chest radiation? This look back at 41 patients receiving thoracic radiation (almost exclusively hypofractionated or SBRT) at MSK subsequent to receiving steroids for an ICI-related adverse event assessed rates and predictors of grade 2+ radiation pneumonitis. First, well over half (n=25) had grade 2+ pneumonitis at a median of 4 months from radiation. The biggest further predictors of radiation pneumonitis were history of ICI-related pneumonitis, among whom 5 of 6 patients were affected, and mean lung dose in a continuous manner—21 of 26 with a mean lung dose >5 Gy were affected. TBL: For patients receiving radiation after prior ICI therapy, a history of ICI-related adverse events may portend an increased risk of radiation pneumonitis. | Shaverdian, Ann Oncol 2020

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