Dr. Hanna on Challenges With Consolidation Immunotherapy in Lung Cancer

Nasser H. Hanna, MD, professor of medicine, Indiana University, discusses challenges in consolation immunotherapy for patients with lung cancer.

The biggest challenge is when patients are given consolidation immunotherapy is typically at the same time patients would naturally get radiation pneumonitis, explains Hanna. Symptoms can include inflammation of the lungs, cough, fever, and shortness of breath. Physicians must decide whether the symptoms are related to radiation or immunotherapy because the management is different, says Hanna.

Immune-related pneumonitis can be very complicated and usually requires a pulmonary and infectious disease consult as well as prolonged steroids, according to Hanna. Atypical infections can occur—including viral, fungal, and bacterial infections—and some patients get bronchiolitis obliterans with organizing pneumonia. A question Hanna has for this patient population is whether patients who have low-grade pneumonitis can be rechallenged with consolidation immunotherapy.

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