Granulomatosis With Polyangiitis in a Patient on Programmed Death-1 Inhibitor for Advanced Non-small-cell Lung Cancer
| Autor: | A Sibille, Michelle Pirotte, Olivier Malaise, Bernard Duysinx, Renaud Louis, Romain Alfieri, Nancy Detrembleur |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Cancer Research medicine.medical_specialty anti-PD-1 antibody immune checkpoint inhibitor Case Report Gastroenterology lcsh:RC254-282 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Lung cancer Adverse effect Pathological Myositis granulomatosis with polyangiitis biology business.industry medicine.disease lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Discontinuation 030104 developmental biology Oncology non-small-cell lung cancer 030220 oncology & carcinogenesis biology.protein immune-related adverse events Antibody Vasculitis Granulomatosis with polyangiitis business |
| Zdroj: | Frontiers in Oncology, Vol 9 (2019) Frontiers in Oncology |
| Popis: | Objectives: To contribute to a precise and thorough knowledge of immune-related adverse events (irAE) induced by immune checkpoint inhibitors (ICI) and to emphasize the importance of this specific form of toxicity in terms of potential predictive value and long-term effects. Materials and Methods: We report the first case of granulomatosis with polyangiitis (GPA) in a patient treated with an anti-Programmed Death protein-1 (PD-1) antibody for advanced non-small-cell lung cancer (NSCLC). Results: After a single dose of this drug the patient showed severe myositis associated with a high anti-PR3 anti-neutrophil cytoplasmic antibody titer. Discontinuation of the anti-PD-1 and introduction of corticoids led to a remission of the irAE. Regarding tumor a partial response was noted. A year later a neutrophilic, sterile pleural exudate and cutaneous lesions appeared with the pathological findings of neutrophilic vasculitis. Retreatment with corticoids induced a new remission of symptoms. It remains unclear whether GPA was preexisting and clinically silent but revealed by the use of ICI or primarily induced by this treatment. Conclusions: irAE are rare when anti-PD-1 antibodies are used in monotherapy. They present with a distinct clinical picture and temporal course and require specific treatment. Patients with irAE usually have a favorable oncological outcome. |
| Databáze: | OpenAIRE |
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