{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T15:18:19Z","timestamp":1784128699300,"version":"3.55.0"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,2,24]],"date-time":"2021-02-24T00:00:00Z","timestamp":1614124800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Science"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Nivolumab can cause interstitial lung disease (ILD), which may be fatal; however, mortality risk factors have not been identified. This postmarketing study evaluated the poor prognostic factors of ILD in nivolumab\u2010treated patients with non\u2013small cell lung cancer (NSCLC) in Japan. Clinical and chest imaging findings for each ILD case were assessed by an expert central review committee, and prognosis was evaluated by radiographic findings, including the presence\/absence of peritumoral ground\u2010glass opacity (peritumoral\u2010GGO). Poor prognostic factors were identified by univariate and multivariate Cox regression analysis. Of the 238 patients with nivolumab\u2010induced ILD, 37 died. The main radiographic patterns of ILD were cryptogenic organizing pneumonia\/chronic eosinophilic pneumonia\u2013like (53.4%), faint infiltration pattern\/acute hypersensitivity pneumonia\u2013like (20.2%), diffuse alveolar damage (DAD)\u2010like (10.9%), and nonspecific interstitial pneumonia\u2013like (6.3%). The main poor prognostic factors identified were DAD\u2010like pattern (highest hazard ratio: 10.72), \u226460\u00a0days from the start of nivolumab treatment to the onset of ILD, pleural effusion before treatment, lesion distribution contralateral or bilateral to the tumor, and abnormal change in C\u2010reactive protein (CRP) levels. Of the 37 deaths due to ILD, 17 had DAD\u2010like radiographic pattern, three had peritumoral\u2010GGO, and five had a change in radiographic pattern from non\u2010DAD at the onset to DAD\u2010like. Patients with NSCLC who develop ILD during nivolumab treatment should be managed carefully if they have poor prognostic factors such as DAD\u2010like radiographic pattern, onset of ILD\u00a0\u226460\u00a0days from nivolumab initiation, pleural effusion before nivolumab treatment, lesion distribution contralateral or bilateral to the tumor, and abnormal changes in CRP levels.<\/jats:p>","DOI":"10.1111\/cas.14710","type":"journal-article","created":{"date-parts":[[2020,10,24]],"date-time":"2020-10-24T18:45:15Z","timestamp":1603565115000},"page":"1495-1505","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Radiographic features and poor prognostic factors of interstitial lung disease with nivolumab for non\u2013small cell lung cancer"],"prefix":"10.1111","volume":"112","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9630-8066","authenticated-orcid":false,"given":"Yoshinobu","family":"Saito","sequence":"first","affiliation":[{"name":"Nippon Medical School Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinichi","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Juntendo University Urayasu Hospital Urayasu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsunori","family":"Oikado","sequence":"additional","affiliation":[{"name":"Cancer Institute Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junya","family":"Tominaga","sequence":"additional","affiliation":[{"name":"Tohoku University School of Medicine Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5414-6510","authenticated-orcid":false,"given":"Masafumi","family":"Sata","sequence":"additional","affiliation":[{"name":"Jichi Medical University Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumikazu","family":"Sakai","sequence":"additional","affiliation":[{"name":"Saitama Medical University International Medical Center Hidaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terufumi","family":"Kato","sequence":"additional","affiliation":[{"name":"Kanagawa Cancer Center Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae","family":"Iwasawa","sequence":"additional","affiliation":[{"name":"Kanagawa Cardiovascular and Respiratory Center Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0590-9259","authenticated-orcid":false,"given":"Hirotsugu","family":"Kenmotsu","sequence":"additional","affiliation":[{"name":"Shizuoka Cancer Center Nagaizumi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiko","family":"Kusumoto","sequence":"additional","affiliation":[{"name":"National Cancer Center Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohisa","family":"Baba","sequence":"additional","affiliation":[{"name":"Kanagawa Cardiovascular and Respiratory Center Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Endo","sequence":"additional","affiliation":[{"name":"Shizuoka Cancer Center Nagaizumi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6981-0800","authenticated-orcid":false,"given":"Yutaka","family":"Fujiwara","sequence":"additional","affiliation":[{"name":"Mitsui Memorial Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Sugiura","sequence":"additional","affiliation":[{"name":"Keio University School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriyo","family":"Yanagawa","sequence":"additional","affiliation":[{"name":"Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiko","family":"Ito","sequence":"additional","affiliation":[{"name":"Ono Pharmaceutical Co., Ltd. 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