Table 3.

Treatment for pneumonitis and follow-up course

Pt	Treatment for pneumonitis#	Admission for pneumonitis	Outcome of pneumonitis treatment	Re-initiation of nivolumab therapy	Recurrent pneumonitis	Details of follow-up and retreatment
1	Oral prednisone taper starting with 120 mg daily	No	Clinical and radiographic improvement	Yes	No	Restarted nivolumab and no recurrent pneumonitis for 46 months
2	IV methylprednisolone taper 240mg daily, IV infliximab (5 mg/kg), ICU admission	Yes	Referred for hospice care and died	No	No	Referred for hospice care and died
3	IV methylprednisolone taper 150mg daily, IV infliximab (5 mg/kg), ICU admission, intubation	Yes	Clinical and radiographic improvement	No	No	Follow-up without therapy; no recurrent pneumonitis for 26 months
4	None◊	No	Radiographic improvement	Yes	No	Restarted maintenance nivolumab monotherapy (3mg/kg, q2w) with no recurrent pneumonitis for 22 months
5	None	No	Clinical and radiographic improvement	No	No	Started on next systemic therapy
6	Oral prednisone 120mg daily	No	Clinical and radiographic improvement	No	No	Started on next systemic therapy
7	Oral prednisone taper starting at 80 mg	No	Clinical and radiographic improvement	Yes	Yes	Restarted nivolumab (3mg/kg, q2w) and developed recurrent pneumonitis after receiving 4 doses of nivolumab*
8	Oral prednisone taper starting at 100 mg	No	Radiographic improvement	No	No	Follow-up without therapy; no recurrent pneumonitis for 3 months
9	Oral steroid taper at outside institution▲	Yes	Clinical and radiographic improvement	No	No	Follow-up without therapy; no recurrent pneumonitis for 7 months
10	None	No	Radiographic improvement	No	No	Started on next systemic therapy
11	IV methylprednisolone 120 mg, then oral prednisone taper starting at 60 mg, and IV infliximab (5 mg/kg)	Yes	Clinical and radiographic improvement	No	No	Referred for palliative care
12	Oral prednisone taper starting at 60 mg daily	Yes	No imaging before next therapy	No	No	Started on next systemic therapy
13	IV methylprednisolone 250 mg, then oral dexamethasone 12 mg daily and prednisone taper starting at 60 mg daily	Yes	Clinical and radiographic improvement	No	No	Referred for palliative care
14	IV methylprednisolone 140 mg daily, then oral prednisone taper starting at 140 mg daily	Yes	Clinical and radiographic improvement	No	No	Started on next systemic therapy
15	Oral prednisone taper starting at 60 mg daily	No	Clinical and radiographic improvement	Yes	No	Restarted nivolumab monotherapy with no recurrent pneumonitis for 5 months
16	Oral prednisone taper starting at 100 mg daily	No	Clinical and radiographic improvement	Yes	Yes	Restarted nivolumab & ipilimumab and received 2 doses of nivolumab & ipilimumab, and 2 doses of nivolmab, developed recurrent pneumonitis**
17	Oral prednisone taper starting at 70 mg daily	No	Clinical and radiographic improvement	No	No	Follow-up without therapy without recurrent pneumonitis for 8 months
18	Oral prednisone taper starting at 40 mg daily	No	Clinical and radiographic improvement	No	No	Started on next systemic therapy
19	Oral prednisone taper starting at 60 mg daily	No	Radiographic improvement	Yes	No	Restarted nivolumab & lirilumab with no recurrent pneumonitis for 2 months
20	Oral prednisone taper starting at 80 mg daily	No	Clinical and radiographic improvement	Yes	No	Restarted nivolumab & lirilumab with no recurrent pneumonitis for 3 months

^#Nivolumab therapy was held at the time of pneumonitis in all patients.

^*Nivolumab was held and the patient was treated again with prednisone taper and improved; followed without rechallenge or therapy for 4 months.

^**Nivolumab was held and the patient was again treated with prednisone taper starting at 100 mg with subsequent improvement; however, the patient experienced two episodes of pneumonitis flare, where a similar pattern of pneumonitis recur after the completion of corticosteroid taper without retreatment of nivolumab or other systemic therapy. (See Fig. 5)

^◊The patient has been on hydrocortisone 15 mg/day for adrenal insufficiency

^▲No further treatment details are available for this patient treated at the outside institution