cliot (version 1.0.0)

irae_pneumonitis_grading: irAE Grading for Pneumonitis (Lung Toxicities)

Description

Calculates the CTCAE severity grade for pneumonitis associated with immune checkpoint inhibitor (ICPi) therapy. Grading is based on clinical symptoms (asymptomatic vs. symptomatic), radiographic findings, and the need for oxygen supplementation or urgent intervention.

Usage

irae_pneumonitis_grading(asymptomatic, symptomatic, severe_symptoms,
                         life_threatening, hypoxia_on_room_air, oxygen_needed,
                         oxygen_management)

Value

A list containing:

CTCAE_Grade

The calculated adverse event grade (0-4).

Definition

Clinical description of the grade.

Management_Recommendation

Guidance on ICPi continuation and immunosuppressive therapy based on ASCO guidelines.

Arguments

asymptomatic

Numeric (0 or 1). Asymptomatic, radiographic findings only? (1 = Yes).

symptomatic

Numeric (0 or 1). Symptomatic (e.g., cough, dyspnea), but not severe? (1 = Yes).

severe_symptoms

Numeric (0 or 1). Severe symptoms or limiting self-care ADL? (1 = Yes).

life_threatening

Numeric (0 or 1). Life-threatening respiratory compromise? (1 = Yes).

hypoxia_on_room_air

Numeric (0 or 1). Hypoxia present on room air? (1 = Yes). Indicates Grade >= 3.

oxygen_needed

Numeric (0 or 1). Oxygen supplementation required? (1 = Yes).

oxygen_management

String. Type of oxygen support (optional for grading logic but useful for context). Options: "none", "low_flow", "high_flow", "intubation".

References

Brahmer JR, Lacchetti C, Schneider BJ, et al. Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: American Society of Clinical Oncology Clinical Practice Guideline. J Clin Oncol. 2018;36(17):1714-1768. doi:10.1200/JCO.2017.77.6385

Examples

# Example 1: Grade 2 (Symptomatic)
# Cough/Dyspnea, No O2 needed
irae_pneumonitis_grading(0, 1, 0, 0, 0, 0, "none")

# Example 2: Grade 3 (Hypoxia)
# Severe symptoms, Hypoxia on room air, O2 needed
irae_pneumonitis_grading(0, 1, 1, 0, 1, 1, "low_flow")