How would the development of pneumonitis from pembrolizumab after treatment as per Keynote 522 alter your PMRT recommendations?   

The patient was a >70-year-old with right-sided cT3N1M0, ypT0N0 TNBC s/p NAC pembro/taxol x 4 cycles followed by mastectomy w SLN (0/4); post-operative course complicated by multiple admissions for dyspnea resulting in discontinuation of immunotherapy due to presumed IO-related pneumonitis, improved with prednisone 40 mg.

The patient did not undergo immediate reconstruction due to concern for prolonged anesthesia.