ICI pneumonitis usually presents 6–12 weeks after initiation of ICI but can be seen sooner in those with underlying pulmonary diseases or primary pulmonary malignancy. Patients often present with fatigue, dyspnea, cough, and hypoxia. They may also develop other irAEs, like skin lesions, colitis, or endocrine complications.

Patients receiving PD-1 therapy are at a higher risk of developing pneumonitis, specifically those with advanced non-small cell lung cancer. This risk can be further increased if they are being co-administered with PD-L1 inhibitors. Underlying interstitial lung disease, tobacco use, or other autoimmune diseases also cause patients to have an increased risk. Pneumonitis due to ICI is a clinical diagnosis without specific radiographic findings, and workup centers on ruling out other causes. Management focuses on cessation of treatment with ICI and may also require treatment with steroids or other immunosuppressives. Ultimately, patients may be reinitiated on ICI with close monitoring for recurrence given higher risk for toxicity.