Immune checkpoint inhibitor pneumonitis can start weeks or months into treatment and may present only as a new cough or breathlessness on exertion. In lung cancer it is easily put down to the tumour or an infection.
Check oxygen saturation at rest and after walking, and have a low threshold for CT when symptoms are new.
- Ask about new cough and breathlessness at every immunotherapy visit.
- Measure oxygen saturation at rest and on exertion.
- Arrange CT promptly when new respiratory symptoms appear on immunotherapy.
- Hold immunotherapy and discuss with the oncology team when pneumonitis is suspected.
Why it matters
Early pneumonitis responds well to steroids; late recognition is where it becomes dangerous.
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