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Immune checkpoint inhibitor pneumonitis — SCE Respiratory MCQ

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HardLung CancerImmune checkpoint inhibitor pneumonitisSCE Respiratory

A 61-year-old woman on pembrolizumab for metastatic NSCLC develops dry cough and dyspnoea. CT shows bilateral organising pneumonia-like infiltrates; infection work-up is negative. Oxygen saturation is 90% on air. What is the most appropriate management?

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Correct answer: A — Hold immunotherapy and start systemic corticosteroids

Symptomatic immune checkpoint inhibitor pneumonitis with hypoxaemia requires holding immunotherapy and starting systemic corticosteroids after excluding infection. Continuing pembrolizumab risks progression to severe pneumonitis. Salbutamol alone and TB therapy do not treat immune-mediated lung inflammation.

Reference: ESMO Immunotherapy Toxicity Guideline; NICE NG122