How do you manage pneumonitis in patients with Stage III NSCLC receiving durvalumab?

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 ...

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...