Targets: CTLA4 (cytotoxic T lymphocyte-associated antigen 4) and PD-L1/PD-1 (programmed death-1)
Risk factors:
(1) combined use of both anti-CTLA4 and anti-PD1 therapies
(2) high dose or prolonged therapy with individual agent
Presentations may include:
(1) cough
(2) dyspnea
(3) hypoxia
(4) respiratory failure
Types of pulmonary involvement:
(1) diffuse alveolar damage syndrome
(2) acute interstitial pneumonitis
(3) organizing inflammatory pneumonia (BOOP)
(4) sarcoidosis-like pulmonary granulomatosis
Complications:
(1) superimposed pneumonia
Differential diagnosis:
(1) radiation pneumonitis
(2) progression of malignancy being treated
(3) comorbid lung disease
