PMC8566897_01
Timeline of prolonged COPD exacerbation on immunotherapy. Oxygen saturation dropped over time after initiation of immunotherapy for Case 1. Important clinical events and data are illustrated in the timeline for reference to the vignette. ICI = Immune checkpoint inhibitor; FEV1 = Forced expiratory volume in 1 second; LAMA = Long-acting muscarinic agonist inhaler; LABA = Long-acting beta agonist inhaler; ICS = Inhaled corticosteroid. The red dashed line represents a pathologic oxygen saturation level. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
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fig1
His Forced Expiratory Volume in 1 second (FEV1) had decreased from 0.86 L to 0.64 L (L) in one month (Fig. 1).
PMC8566897_02
Serial imaging of COPD exacerbation on immunotherapy. Representative apical, mid and basilar lung fields are shown by timepoint in columns for Case 2. There was no evidence of pneumonitis or another pulmonary cause of this patient's breathing difficulties and a cardiac evaluation was negative.
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Her CT scans prior to ICI initiation and at months 1, 4, and 7 demonstrated no evidence of pneumonitis (Fig. 2).