How do you manage steroid-refractory immune checkpoint inhibitor induced pneumonitis?

Steroid-refractory immune checkpoint inhibitor (ICI)-induced pneumonitis is managed with high-dose steroids plus an additional immunosuppressive agent, like infliximab or intravenous immunoglobulin (IVIG) among others. I recommend early immunomodulatory escalation as multiple studies have shown that...

• Great question: data is still being collected and we still need to define what ICI-pneumonitis is by classification, vs radiation pneumonitis vs an IPF like disease .
• We use IVIG as well as azathioprine and cellcept as steroid sparing options.
• More studies are needed to diagnose, classify and trea...

Most immunotherapy-related pneumonitis is corticosteroid responsive, though some patients may demonstrate relapsing symptoms and radiographic findings if steroids are tapered before inflammation has resolved. In patients with more organizing-pneumonia-like features to their reaction, a rapid taper m...

This is a good question and unfortunately becoming more frequent. The bottom line is that to my knowledge at least, we have no good prospective data - let alone results of randomized clinical trials - to guide decision making. Based on some recent retrospective data (here and here for instance), as ...