ArticleJournal for immunotherapy of cancer2024
Krebs von den Lungen-6 surveillance in immune checkpoint inhibitor-induced pneumonitis.
Article in Journal for immunotherapy of cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Diagnostic research in immune checkpoint inhibitor-related pneumonitis: a bibliometric analysis of research evolution, diagnostic focuses, and future priorities.Frontiers in oncology · 2026Pooled it
- CT-based deep foundation model for predicting immune checkpoint inhibitor-induced pneumonitis risk in lung cancer.Journal for immunotherapy of cancer · 2026Article
- Clinical Characteristics and Risk Factors for Severe Immune-Related Liver Injury Following Nivolumab and Ipilimumab Combination Therapy.Antibodies (Basel, Switzerland) · 2026Article
- Narrative review of the similarities and differences between immune checkpoint inhibitor- and antibody-drug conjugate-associated pneumonitis.Translational lung cancer research · 2026Review
- Serial KL-6 Changes in PD-1/PD-L1 Inhibitor-Related Pneumonitis in Non-small Cell Lung Cancer: A Single-Center Prospective Pilot Study.Tuberculosis and respiratory diseases · 2026Article
- Clinical characteristics, prognostic factors, and feasibility of ICI continuation in immune checkpoint inhibitor-related pneumonitis.Cancer immunology, immunotherapy : CII · 2026Article
- Nurse-coordinated biomarker and symptom monitoring for immune checkpoint inhibitor toxicity.Frontiers in medicine · 2026Review
- Biomarker study on pneumonitis in durvalumab maintenance therapy after chemoradiotherapy for stage III non-small cell lung cancer.BMC cancer · 2025Article
- Uncovering the immune mechanisms underlying the emergence of immunotherapy-induced pneumonitis in lung cancer patients.Nature communications · 2025Article
- [Risk Factors, Molecular Mechanisms, and Multimodal Early Warning Strategies for Immune Checkpoint Inhibitor-associated Pneumonitis in Lung Cancer].Zhongguo fei ai za zhi = Chinese journal of lung cancer · 2025Review
- Unveiling the global research status and intellectual map of cancer and immunosuppressants.Discover oncology · 2025Article
- Application of Immune Checkpoint Inhibitors in Cancer.MedComm · 2025Review
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10 authors.
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Abstract
backgroundThe immune-related adverse event (irAE), pneumonitis, is a potentially fatal complication of immune checkpoint inhibitors (ICIs). Preventing its progression is crucial, emphasizing the need for effective screening tests. We evaluated the feasibility of using Krebs von den Lungen-6 (KL-6), a marker for interstitial pneumonitis, as a screening tool for pneumonitis.
methodsWe examined 500 patients with cancer divided into two groups: those with cancer other than non-small cell lung cancer (NSCLC) (Group 1, n=382) and those with NSCLC (Group 2, n=118). KL-6 levels were monitored before and during ICI treatment and analyzed for their correlation with pneumonitis.
resultsIn Group 1, 37 patients (9.7%) developed pneumonitis. KL-6 levels were significantly elevated at irAE onset (pre: 222.0 U/mL, post: 743.0 U/mL, p<0.0001). Receiver operating characteristic curve analysis showed an area under the curve (AUC) of 0.903 (sensitivity 81.1%, specificity 91.6%) with a cut-off value 1.52 times pre-KL-6 levels, indicating that KL-6 is a reliable biomarker for pneumonitis. In these patients, the KL-6 level increased regardless of pneumonitis severity and was significantly elevated in patients with both symptomatic (pre: 205.0 U/mL, post: 674.5 U/mL, p<0.0001) and asymptomatic pneumonitis (pre: 314.0 U/mL, post: 743.0 U/mL, p<0.0001) at irAE onset. After irAE treatment, KL-6 levels in steroid-responsive patients remained unchanged; however, steroid-unresponsive patients had a significant increase in KL-6 levels at 1 month (1078 U/mL, p=0.031) compared with at irAE onset (678.0 U/mL). In Group 2, 24 patients (20.3%) developed irAE pneumonitis, with KL-6 levels elevated (pre: 360.5 U/mL, post: 506.5 U/mL, p=0.029) and an AUC of 0.683, indicating that KL-6 was less reliable in patients with NSCLC.
conclusionsKL-6 is a viable screening biomarker in ICI-induced pneumonitis, particularly in patients without NSCLC. In patients with NSCLC, the significance of KL-6 monitoring is limited as it is not effective for detecting ICI-induced pneumonitis; their treatment is typically managed by pulmonary specialists. Early detection through KL-6 monitoring facilitates timely intervention for ICI-induced pneumonitis, potentially preventing treatment interruptions and reducing the need for immunosuppressants.
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