Pulmonary complications of targeted therapy
-Immune checkpoint inhibitors (e.g. pembrolizumab)
-Pneumonitis is uncommon (~5% of patients) but can be severe.
-It’s a diagnosis of exclusion: rule out infection and malignancy-associated pnuemonitis, as well as radiation pneumonitis.
-Can occur at any time during therapy.
-1/3 of patients are asymptomatic, and the most common presenting symptom is cough
-Imaging characteristics vary widely. There are case reports of pleural effusion associated with a clinical diagnosis pneumonitis, but it’s unclear if this is a drug side effect or a “reactive” response to cancer cell death in response to therapy.

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