332 Background: Pneumonitis is a known adverse effect (AE) of mammalian target of rapamycin-inhibitors, with a literature reported incidence for everolimus ranging from 4 to 45%. The goal of this review was to characterize the incidence, timing, management, and outcomes related to everolimus-associated pneumonitis (EAP). Methods: Retrospective review of 86 mRCC patients (pts) with complete, evaluable records, given everolimus (E) between 4/2009 and 3/2010. We assessed baseline patient (pt) characteristics, previous therapies, time on E therapy, pt symptoms, physician management of AE, NCI-CTC pneumonitis grading, and survival outcomes. Radiologic CT indicated ground glass, inflammatory, and/or parenchymal opacities. Results: (See table.) EAP occurred in 28% of pts on E therapy, confirmed radiologically. 8% of EAP patients reported no symptoms. In EAP pts, 58% reported cough, 75% dyspnea and/or SOB, 17% fever, 71% fatigue. The median number of symptoms/patient was 3. 46% of pts received steroids (median 21 days (3-120)), 38% received antibiotics, 25% received pulmonary consultation, and 8% required oxygen. In pts who developed EAP, providers discontinued E in 75%, held and dose reduced E in 8%, and continued E in 17%. The median NCI-CTC pneumonitis grade was 2 (1-3); there were no treatment-related deaths. The median time to EAP onset was 67 days (8-442). There was no statistically significant difference in outcomes between EAP pts and non-EAP pts. Conclusions: EAP occurs often in mRCC pts treated with E. It is an important AE that can negatively affect pt symptoms, but did not adversely impact pt outcomes in our single-center experience. [Table: see text] [Table: see text]