Evaluating the effect of immune checkpoint inhibitor treatment on chronic obstructive pulmonary disease in lung cancer patients

Immune checkpoint inhibitors (ICIs) are first line treatment for advanced lung cancer. Tobacco use is a shared risk factor for lung cancer and chronic obstructive pulmonary disease (COPD). Although many patients with COPD and lung cancer receive ICIs, the impact of ICIs on COPD is unknown. Here, we...

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Main Authors: Anet Greib, Songzhu Zhao, Michelle Ploch, Jonathan Henricks, Robert Easterling, Meghana Moodabagil, Gabrielle Lopez, Mingjia Li, Evelyn G. Goodyear, John Sharp, Asrar Alahmadi, Jacob Kaufman, Regan Memmott, Kai He, Peter Shields, David P. Carbone, Gregory A. Otterson, Carolyn J. Presley, Lai Wei, Dwight H. Owen, Kevin Ho
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:OncoImmunology
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Online Access:https://www.tandfonline.com/doi/10.1080/2162402X.2025.2469375
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author Anet Greib
Songzhu Zhao
Michelle Ploch
Jonathan Henricks
Robert Easterling
Meghana Moodabagil
Gabrielle Lopez
Mingjia Li
Evelyn G. Goodyear
John Sharp
Asrar Alahmadi
Jacob Kaufman
Regan Memmott
Kai He
Peter Shields
David P. Carbone
Gregory A. Otterson
Carolyn J. Presley
Lai Wei
Dwight H. Owen
Kevin Ho
author_facet Anet Greib
Songzhu Zhao
Michelle Ploch
Jonathan Henricks
Robert Easterling
Meghana Moodabagil
Gabrielle Lopez
Mingjia Li
Evelyn G. Goodyear
John Sharp
Asrar Alahmadi
Jacob Kaufman
Regan Memmott
Kai He
Peter Shields
David P. Carbone
Gregory A. Otterson
Carolyn J. Presley
Lai Wei
Dwight H. Owen
Kevin Ho
author_sort Anet Greib
collection DOAJ
description Immune checkpoint inhibitors (ICIs) are first line treatment for advanced lung cancer. Tobacco use is a shared risk factor for lung cancer and chronic obstructive pulmonary disease (COPD). Although many patients with COPD and lung cancer receive ICIs, the impact of ICIs on COPD is unknown. Here, we evaluated whether ICI treatment was associated with increased COPD disease burden. We conducted a retrospective cohort study of lung cancer patients with and without preexisting COPD who received ICIs from 2011–2021 at The Ohio State University (OSU). For all patients, number of steroid courses and respiratory related hospitalizations were recorded. For those with COPD, COPD medications were collected at and after ICI initiation. Pulmonary function tests, COPD exacerbations, and COPD-related hospitalizations were compared before and after ICI treatment. Linear and generalized mixed models were used to account for potential confounders of worsening COPD. Among 1083 lung cancer patients who received ICIs, 585 (54.0%) had pre-ICI COPD. Patients with COPD were prescribed more COPD medications (3 [1, 4] vs 1 [0, 3], p < 0.001), had more COPD exacerbations (38.3% vs 25.8%, p < 0.001), and more COPD-related hospitalizations (27.9% vs 16.9%, p < 0.001) after ICI initiation compared to before. These findings persisted after multivariable analysis controlling for patients who received chemotherapy or chemoradiation within 12 months of ICI initiation, cancer type, age, BMI, sex, smoking status, type of ICI, and number of ICI doses (p < 0.001). This is a comprehensive study that describes lung cancer patients with COPD treated with ICIs have increased COPD disease burden after ICI initiation.
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spelling doaj-art-20a6669aa2f042edbd05caa7e82b91182025-08-20T03:48:27ZengTaylor & Francis GroupOncoImmunology2162-402X2025-12-0114110.1080/2162402X.2025.2469375Evaluating the effect of immune checkpoint inhibitor treatment on chronic obstructive pulmonary disease in lung cancer patientsAnet Greib0Songzhu Zhao1Michelle Ploch2Jonathan Henricks3Robert Easterling4Meghana Moodabagil5Gabrielle Lopez6Mingjia Li7Evelyn G. Goodyear8John Sharp9Asrar Alahmadi10Jacob Kaufman11Regan Memmott12Kai He13Peter Shields14David P. Carbone15Gregory A. Otterson16Carolyn J. Presley17Lai Wei18Dwight H. Owen19Kevin Ho20Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USACenter for Biostatistics, The Ohio State University – James Comprehensive Cancer Center, Columbus, OH, USADivision of Pulmonary, Critical Care and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USADepartments of Internal Medicine and Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USADepartment of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USADepartments of Internal Medicine and Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USADivision of Medical Oncology, Department of Internal Medicine, The Ohio State University - James Comprehensive Cancer Center, Columbus, OH, USADivision of Medical Oncology, Department of Internal Medicine, The Ohio State University - James Comprehensive Cancer Center, Columbus, OH, USAThe Ohio State University College of Medicine, Columbus, OH, USADivision of Medical Oncology, Department of Internal Medicine, The Ohio State University - James Comprehensive Cancer Center, Columbus, OH, USADivision of Medical Oncology, Department of Internal Medicine, The Ohio State University - James Comprehensive Cancer Center, Columbus, OH, USADivision of Medical Oncology, Department of Internal Medicine, The Ohio State University - James Comprehensive Cancer Center, Columbus, OH, USADivision of Medical Oncology, Department of Internal Medicine, The Ohio State University - James Comprehensive Cancer Center, Columbus, OH, USADivision of Medical Oncology, Department of Internal Medicine, The Ohio State University - James Comprehensive Cancer Center, Columbus, OH, USADivision of Medical Oncology, Department of Internal Medicine, The Ohio State University - James Comprehensive Cancer Center, Columbus, OH, USADivision of Medical Oncology, Department of Internal Medicine, The Ohio State University - James Comprehensive Cancer Center, Columbus, OH, USADivision of Medical Oncology, Department of Internal Medicine, The Ohio State University - James Comprehensive Cancer Center, Columbus, OH, USADivision of Medical Oncology, Department of Internal Medicine, The Ohio State University - James Comprehensive Cancer Center, Columbus, OH, USACenter for Biostatistics, The Ohio State University – James Comprehensive Cancer Center, Columbus, OH, USADivision of Medical Oncology, Department of Internal Medicine, The Ohio State University - James Comprehensive Cancer Center, Columbus, OH, USADivision of Pulmonary, Critical Care and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USAImmune checkpoint inhibitors (ICIs) are first line treatment for advanced lung cancer. Tobacco use is a shared risk factor for lung cancer and chronic obstructive pulmonary disease (COPD). Although many patients with COPD and lung cancer receive ICIs, the impact of ICIs on COPD is unknown. Here, we evaluated whether ICI treatment was associated with increased COPD disease burden. We conducted a retrospective cohort study of lung cancer patients with and without preexisting COPD who received ICIs from 2011–2021 at The Ohio State University (OSU). For all patients, number of steroid courses and respiratory related hospitalizations were recorded. For those with COPD, COPD medications were collected at and after ICI initiation. Pulmonary function tests, COPD exacerbations, and COPD-related hospitalizations were compared before and after ICI treatment. Linear and generalized mixed models were used to account for potential confounders of worsening COPD. Among 1083 lung cancer patients who received ICIs, 585 (54.0%) had pre-ICI COPD. Patients with COPD were prescribed more COPD medications (3 [1, 4] vs 1 [0, 3], p < 0.001), had more COPD exacerbations (38.3% vs 25.8%, p < 0.001), and more COPD-related hospitalizations (27.9% vs 16.9%, p < 0.001) after ICI initiation compared to before. These findings persisted after multivariable analysis controlling for patients who received chemotherapy or chemoradiation within 12 months of ICI initiation, cancer type, age, BMI, sex, smoking status, type of ICI, and number of ICI doses (p < 0.001). This is a comprehensive study that describes lung cancer patients with COPD treated with ICIs have increased COPD disease burden after ICI initiation.https://www.tandfonline.com/doi/10.1080/2162402X.2025.2469375Chronic obstructive pulmonary disease (COPD)immune checkpoint inhibitors (ICI)lung cancer
spellingShingle Anet Greib
Songzhu Zhao
Michelle Ploch
Jonathan Henricks
Robert Easterling
Meghana Moodabagil
Gabrielle Lopez
Mingjia Li
Evelyn G. Goodyear
John Sharp
Asrar Alahmadi
Jacob Kaufman
Regan Memmott
Kai He
Peter Shields
David P. Carbone
Gregory A. Otterson
Carolyn J. Presley
Lai Wei
Dwight H. Owen
Kevin Ho
Evaluating the effect of immune checkpoint inhibitor treatment on chronic obstructive pulmonary disease in lung cancer patients
OncoImmunology
Chronic obstructive pulmonary disease (COPD)
immune checkpoint inhibitors (ICI)
lung cancer
title Evaluating the effect of immune checkpoint inhibitor treatment on chronic obstructive pulmonary disease in lung cancer patients
title_full Evaluating the effect of immune checkpoint inhibitor treatment on chronic obstructive pulmonary disease in lung cancer patients
title_fullStr Evaluating the effect of immune checkpoint inhibitor treatment on chronic obstructive pulmonary disease in lung cancer patients
title_full_unstemmed Evaluating the effect of immune checkpoint inhibitor treatment on chronic obstructive pulmonary disease in lung cancer patients
title_short Evaluating the effect of immune checkpoint inhibitor treatment on chronic obstructive pulmonary disease in lung cancer patients
title_sort evaluating the effect of immune checkpoint inhibitor treatment on chronic obstructive pulmonary disease in lung cancer patients
topic Chronic obstructive pulmonary disease (COPD)
immune checkpoint inhibitors (ICI)
lung cancer
url https://www.tandfonline.com/doi/10.1080/2162402X.2025.2469375
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