Safety of Extended-Interval Dosing Strategy of Immune Checkpoint Inhibitors for Advanced NSCLC.

We read with great interest the study of Higashiyama et al.1 describing the safety of pembrolizumab dose doubling in a monocentric retrospective study. A high percentage of grade 3 or 4 immune-related adverse events (irAEs) were observed in their cohorts. Indeed, 38% (17 of 45) of patients experienced irAEs during the first cycles of double-dose immune checkpoint inhibitor (ICI), including 47.1% (eight of 17) of grade greater than or equal to 3 toxicities. Of note, most of the irAEs were pneumonitis (n = 11) and seven patients had to discontinue definitely the immunotherapy.