Risk Factors and Biomarkers for Pulmonary Toxicities Associated with Immune Checkpoint Inhibitors
<i>Background and Objectives</i>: Immune checkpoint inhibitors (ICIs) have emerged as groundbreaking agents in cancer therapy; however, their immune-related adverse effects, especially pulmonary toxicity, significantly limit their use. This study aimed to determine the incidence and risk...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-07-01
|
| Series: | Medicina |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1648-9144/61/7/1258 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849733762938568704 |
|---|---|
| author | Efraim Guzel Ismail Hanta Oya Baydar Toprak Okan Gurbuz Burak Mete Ertugrul Bayram |
| author_facet | Efraim Guzel Ismail Hanta Oya Baydar Toprak Okan Gurbuz Burak Mete Ertugrul Bayram |
| author_sort | Efraim Guzel |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Immune checkpoint inhibitors (ICIs) have emerged as groundbreaking agents in cancer therapy; however, their immune-related adverse effects, especially pulmonary toxicity, significantly limit their use. This study aimed to determine the incidence and risk factors associated with ICI-induced pulmonary toxicity. <i>Materials and Methods</i>: We conducted a prospective observational study involving 126 patients aged ≥18 years with malignancies treated with ICIs between April 2022 and April 2024. Patients were followed every six months over a two-year period. Clinical, laboratory, and radiological data were collected to assess pulmonary toxicity. <i>Results</i>: The mean age of our patients was 62.93 ± 12.94 years, and 81% were male. The ICI-related pulmonary toxicity rate was 16.7%, and the all-cause mortality rate was 68.3%. In the analysis, the conditions associated with pulmonary toxicity were the type of malignancy, the presence of lung cancer, COPD, long-term ICI use, dyspnea, cough and sputum, the pre-ICI lung nodule mass, and high blood monocyte levels. Our regression analysis results for the determination of risk factors showed a 7.70-fold increase in the presence of cough symptoms, a 4.57-fold increase in the presence of COPD, a 0.998-fold increase for every 1 unit decrease in lymphocyte count, and an 11.75-fold increase in risk for a monocyte count of 130 or less. <i>Conclusions</i>: Our study’s findings suggest that patients with identifiable risk factors for pulmonary toxicity should undergo closer monitoring and early diagnostic evaluation during ICI therapy to reduce morbidity and mortality. |
| format | Article |
| id | doaj-art-3cbcfb6b067b4ae385f5cf2c3be0419e |
| institution | DOAJ |
| issn | 1010-660X 1648-9144 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj-art-3cbcfb6b067b4ae385f5cf2c3be0419e2025-08-20T03:07:58ZengMDPI AGMedicina1010-660X1648-91442025-07-01617125810.3390/medicina61071258Risk Factors and Biomarkers for Pulmonary Toxicities Associated with Immune Checkpoint InhibitorsEfraim Guzel0Ismail Hanta1Oya Baydar Toprak2Okan Gurbuz3Burak Mete4Ertugrul Bayram5Department of Chest Diseases, Faculty of Medicine, Cukurova University, 01330 Adana, TurkeyDepartment of Chest Diseases, Faculty of Medicine, Cukurova University, 01330 Adana, TurkeyDepartment of Chest Diseases, Faculty of Medicine, Cukurova University, 01330 Adana, TurkeyDepartment of Chest Diseases, Faculty of Medicine, Cukurova University, 01330 Adana, TurkeyDepartment of Public Health, Faculty of Medicine, Cukurova University, 01330 Adana, TurkeyDepartment of Medical Oncology, Faculty of Medicine, Cukurova University, 01330 Adana, Turkey<i>Background and Objectives</i>: Immune checkpoint inhibitors (ICIs) have emerged as groundbreaking agents in cancer therapy; however, their immune-related adverse effects, especially pulmonary toxicity, significantly limit their use. This study aimed to determine the incidence and risk factors associated with ICI-induced pulmonary toxicity. <i>Materials and Methods</i>: We conducted a prospective observational study involving 126 patients aged ≥18 years with malignancies treated with ICIs between April 2022 and April 2024. Patients were followed every six months over a two-year period. Clinical, laboratory, and radiological data were collected to assess pulmonary toxicity. <i>Results</i>: The mean age of our patients was 62.93 ± 12.94 years, and 81% were male. The ICI-related pulmonary toxicity rate was 16.7%, and the all-cause mortality rate was 68.3%. In the analysis, the conditions associated with pulmonary toxicity were the type of malignancy, the presence of lung cancer, COPD, long-term ICI use, dyspnea, cough and sputum, the pre-ICI lung nodule mass, and high blood monocyte levels. Our regression analysis results for the determination of risk factors showed a 7.70-fold increase in the presence of cough symptoms, a 4.57-fold increase in the presence of COPD, a 0.998-fold increase for every 1 unit decrease in lymphocyte count, and an 11.75-fold increase in risk for a monocyte count of 130 or less. <i>Conclusions</i>: Our study’s findings suggest that patients with identifiable risk factors for pulmonary toxicity should undergo closer monitoring and early diagnostic evaluation during ICI therapy to reduce morbidity and mortality.https://www.mdpi.com/1648-9144/61/7/1258immune checkpoint inhibitorimmunotherapypulmonary toxicityorganizing pneumoniainterstitial pneumoniahypersensitivity pneumonitis |
| spellingShingle | Efraim Guzel Ismail Hanta Oya Baydar Toprak Okan Gurbuz Burak Mete Ertugrul Bayram Risk Factors and Biomarkers for Pulmonary Toxicities Associated with Immune Checkpoint Inhibitors Medicina immune checkpoint inhibitor immunotherapy pulmonary toxicity organizing pneumonia interstitial pneumonia hypersensitivity pneumonitis |
| title | Risk Factors and Biomarkers for Pulmonary Toxicities Associated with Immune Checkpoint Inhibitors |
| title_full | Risk Factors and Biomarkers for Pulmonary Toxicities Associated with Immune Checkpoint Inhibitors |
| title_fullStr | Risk Factors and Biomarkers for Pulmonary Toxicities Associated with Immune Checkpoint Inhibitors |
| title_full_unstemmed | Risk Factors and Biomarkers for Pulmonary Toxicities Associated with Immune Checkpoint Inhibitors |
| title_short | Risk Factors and Biomarkers for Pulmonary Toxicities Associated with Immune Checkpoint Inhibitors |
| title_sort | risk factors and biomarkers for pulmonary toxicities associated with immune checkpoint inhibitors |
| topic | immune checkpoint inhibitor immunotherapy pulmonary toxicity organizing pneumonia interstitial pneumonia hypersensitivity pneumonitis |
| url | https://www.mdpi.com/1648-9144/61/7/1258 |
| work_keys_str_mv | AT efraimguzel riskfactorsandbiomarkersforpulmonarytoxicitiesassociatedwithimmunecheckpointinhibitors AT ismailhanta riskfactorsandbiomarkersforpulmonarytoxicitiesassociatedwithimmunecheckpointinhibitors AT oyabaydartoprak riskfactorsandbiomarkersforpulmonarytoxicitiesassociatedwithimmunecheckpointinhibitors AT okangurbuz riskfactorsandbiomarkersforpulmonarytoxicitiesassociatedwithimmunecheckpointinhibitors AT burakmete riskfactorsandbiomarkersforpulmonarytoxicitiesassociatedwithimmunecheckpointinhibitors AT ertugrulbayram riskfactorsandbiomarkersforpulmonarytoxicitiesassociatedwithimmunecheckpointinhibitors |