Pneumonitis is a recognised, sometimes fatal, immune-related adverse event, and its symptoms are non-specific. In any patient on a checkpoint inhibitor with new or worsening cough, breathlessness or hypoxia, think of pneumonitis alongside infection and disease progression.
Established practice is to image the chest, exclude infection, hold the immunotherapy and discuss corticosteroids with the oncology team according to grade.
- Ask about new cough or breathlessness at every immunotherapy visit.
- Check oxygen saturation, including on exertion.
- Arrange chest imaging and exclude infection.
- Hold immunotherapy and involve the oncology team promptly.
- Counsel patients to report respiratory symptoms early.
Why it matters
Delay in recognising pneumonitis is a common reason it becomes severe.
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