Table 1.

Review of center's experience of potential COPD exacerbations on immunotherapy.

ID	Age (years)	Sex	Smoking Status	Cancer Type	ICI Therapy	PDL1 IHC	CT features	FEV1 (L) Pre-	FEV1 (L) Post-	Blood Eosinophilia†	Summary
1	81	M	past	Melanoma	2 doses, Nivolumab	*	COPD	*	0.86	Y	See text, Case 1
2	76	F	past	Lung AC	6 doses, Pembrolizumab	15%	COPD	1.1	1.02	Y	See text, Case 2
3	80	M	past	SCLC	3 doses, Nivolumab/ Ipilumimab	*	COPD/ ILD	*	2.83	N	Developed oxygen requirements after 2 doses of ICI that increased from 3 to 5 L per minute (LPM). Prednisone courses twice, now oxygen dependent. Serial CTs show severe para-septal emphysema. Cardiac function evaluated and normal during this course. NED at 15 months from ICI initiation.
4	75	F	current	Lung SCC	13 doses, Pembrolizumab	0	COPD	0.52	*	N	Treated for cT2 disease by radiation, with early recurrence. Received chemotherapy followed by ICI resulting in multiple exacerbations and one admission for COPD. Expired from disease progression and comorbidities 21 months after ICI initiation.
5	80	M	past	Lung AC	9 doses, Pembrolizumab	80%	COPD	0.89	*	N	cT2 disease treated with radiation with early recurrence. COPD exacerbation after 3 months of ICI resulting in 1 year drug holiday between dose 6 and 7. Dies from disease progression 18 months after ICI initiation.
6	85	M	past	Lung AC	4 doses, Pembrolizumab	0	Pneumonia/ COPD	*	*	Y	Underwent ICI for recurrent disease after radiation for clinical stage I disease. Multiple COPD exacerbations and pneumonia following. Dies 1 year after ICI initiation from COPD with NED.

† Defined as Absolute Eosinophil Count (AEC) ≥ 0.5.

* Data not available.

M = Male, F = Female.

ICI = Immune checkpoint inhibitor.

IHC = Immunohistochemistry.

FEV₁ = Forced expiratory volume in 1 second.

AC = Adenocarcinoma, SCLC = Small cell lung cancer, SCC = Squamous cell carcinoma.

NED = No evidence of disease.