Pneumonitis history OR active interstitial lung disease (ILD) — limits ICI (pembrolizumab...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

ID	`RF-NSCLC-ORGAN-DYSFUNCTION`
Type	Red flag
Status	pending_clinical_signoff
Diseases	`DIS-NSCLC`
Sources	`SRC-ESMO-NSCLC-METASTATIC-2024` `SRC-NCCN-NSCLC-2025`

Red Flag Origin

Definition	Pneumonitis history OR active interstitial lung disease (ILD) — limits ICI (pembrolizumab, atezolizumab, durvalumab, nivolumab) and T-DXd; PACIFIC durvalumab consolidation contraindicated if symptomatic post-CRT pneumonitis.
Clinical direction	hold
Category	organ-dysfunction

Trigger Logic

{
  "any_of": [
    {
      "finding": "ild_active_or_history",
      "value": true
    },
    {
      "finding": "post_crt_pneumonitis_grade_2_or_higher",
      "value": true
    }
  ],
  "type": "composite_clinical"
}

Notes

Pneumonitis is the most common ICI / T-DXd-related lethal AE. Pre-treatment screen + serial monitoring; immediate hold on any new respiratory symptoms during ICI therapy.

Used By

Indications

IND-NSCLC-STAGE-III-PACIFIC - IND-NSCLC-STAGE-III-PACIFIC