How do you manage pneumonitis in patients with Stage III NSCLC receiving durvalumab?
How do you prescribe a steroid taper? If it is grade 2, would you keep them on low dose prednisone while continuing? When do you feel comfortable re-challenging with durvalumab?
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Do you re-challenge patients with durvalumab after they have had pneumonitis requiring steroids?
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2 Answers
Mednet MemberInvited Expert
Medical Oncology · Cedars-Sinai Medical Center
Answered on
Pneumonitis is a concern following chemoradiation (CRT) alone, and the addition of durvalumab leads to increased caution. Patients on the durvalumab arm in the PACIFIC trial, had some increase in pulmonary adverse events. Any-grade cough (35.4%) and pneumonitis or radiation pneumonitis (33.9%) were ...
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Mednet Member
Medical Oncology · Tufts University School of Medicine
Answered on
There is slight increase in incidence of pneumonitis after Durvalumab. It is difficult to differentiate radiation and immunotherapy related pneumonitis. I follow grade 1 pneumonitis closely and only start steroids with grade 2 or above. If symptoms get better to grade 2 or less and prednisone <10-20...
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