All patients were diagnosed and treated according to the expert consensus on the diagnosis and treatment of immune checkpoint inhibitor-related pneumonia in lung cancer patients.
Symptomatic supportive treatment was provided for grade 1 ICIP with close follow-up evaluation. Intravenous administration of methylprednisolone (1–2 mg/kg/d) was administered first for grade 2 ICIP, followed by oral administration of methylprednisolone (1–2 mg/kg/d) after 48 to 72 hours. Steroid treatment was gradually tapered (10 mg/week) after the symptoms abated and imaging improved; the treatment course was > 6 weeks. Intravenous administration of methylprednisolone (2–4 mg/kg/d) was administered first for grade 3 and 4 ICIP, followed by oral administration of methylprednisolone (2–4 mg/kg/d) after 48 to 72 hours. Steroid treatment was gradually tapered (10 mg per week) after the symptoms abated and imaging improved; the treatment course was > 8 weeks. There were 30 cases in the glucocorticoid alone group and 15 cases in the glucocorticoid-pirfenidone group, in which pirfenidone (approval number: National Drug Approval H20133375; Beijing Kontine Pharmaceutical Co., Ltd., Beijing) was added to the steroid treatment. The treatment regimen consisted of pirfenidone (100 mg) administered thrice-daily for a duration of 7 days, followed by pirfenidone (200 mg) administered thrice-daily for 14 days. Maintenance pirfenidone therapy was then initiated at a dose of 300 mg administered thrice-daily.
Symptomatic supportive treatment was provided for grade 1 ICIP with close follow-up evaluation. Intravenous administration of methylprednisolone (1–2 mg/kg/d) was administered first for grade 2 ICIP, followed by oral administration of methylprednisolone (1–2 mg/kg/d) after 48 to 72 hours. Steroid treatment was gradually tapered (10 mg/week) after the symptoms abated and imaging improved; the treatment course was > 6 weeks. Intravenous administration of methylprednisolone (2–4 mg/kg/d) was administered first for grade 3 and 4 ICIP, followed by oral administration of methylprednisolone (2–4 mg/kg/d) after 48 to 72 hours. Steroid treatment was gradually tapered (10 mg per week) after the symptoms abated and imaging improved; the treatment course was > 8 weeks. There were 30 cases in the glucocorticoid alone group and 15 cases in the glucocorticoid-pirfenidone group, in which pirfenidone (approval number: National Drug Approval H20133375; Beijing Kontine Pharmaceutical Co., Ltd., Beijing) was added to the steroid treatment. The treatment regimen consisted of pirfenidone (100 mg) administered thrice-daily for a duration of 7 days, followed by pirfenidone (200 mg) administered thrice-daily for 14 days. Maintenance pirfenidone therapy was then initiated at a dose of 300 mg administered thrice-daily.
