Skill Checkup: A 48-Year-Old Triple-Negative Breast Cancer Patient Falls Ill During Immune Checkpoint Inhibitor Therapy

Kelly E. McCann, MD, PhD


May 24, 2022

Current recommendations advise that in the context of immune-related pneumonitis, patients may be cautiously retreated when symptoms and imaging abnormalities have resolved (grade 0) and when steroids have been discontinued.

Retreatment with ICIs is contraindicated in the setting of a life-threatening toxicity, particularly when cardiac, pulmonary, or neurologic in nature. Reintroduction of ICI should not be attempted after development of grade 4 pneumonitis.

Critically, the clinician must consider if the possible benefit of immunotherapy in a subset of TNBCs justifies the risk for a life-threatening toxicity. For example, as evidenced in the present case, pneumonitis can be subtle and progress quickly.

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