Immune-related organizing pneumonitis in non-small cell lung cancer receiving PD-1 inhibitor treatment: A case report and literature review

被引:6
作者
Yin, Beibei [1 ,2 ]
Xiao, Junjuan [1 ,2 ]
Li, Junwei [1 ,2 ]
Liu, Xiaohong [3 ]
Wang, Jun [1 ,2 ]
机构
[1] Shandong First Med Univ, Dept Oncol, Affiliated Hosp 1, Jinan, Peoples R China
[2] Shandong Prov Qianfoshan Hosp, Shandong Lung Canc Inst, Jinan, Peoples R China
[3] 960 Hosp, Dept Pathol, Peoples Liberat Army, Jinan, Peoples R China
基金
中国国家自然科学基金;
关键词
immune checkpoint inhibitor; immune-related adverse event; nonsmall cell lung cancer; organizing pneumonia; programmed cell death 1 inhibitor; programmed cell death ligand 1;
D O I
10.4103/jcrt.JCRT_971_20
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Immune checkpoint blockade with programmed cell death protein-1 (PD-1)/programmed cell death ligand-1 (PD-L1) inhibitors has been standard care for metastatic nonsmall cell lung cancer (NSCLC) and after progression using first-line platinum-containing chemotherapy. Although several management guidelines exist for immune checkpoint inhibitor-induced toxicities, uncommon, complicated, and life-threatening immune-related adverse events remain challenging for oncologists. In this report, we presented a male patient with NSCLC who received pembrolizumab during disease progression. He developed interstitial pembrolizumab-induced organizing pneumonia (OP). The patient received 9 months of anti-PD-1 pembrolizumab when he presented with dry cough and fatigue. The patient developed a solitary nodular lung lesion mimicking a newly occurred metastatic lesion in the lung without a significant circulating tumor marker increase. Sputum analysis was negative for acid-fast bacilli and fungi. A computed tomography-guided percutaneous lung biopsy was conducted and showed alveolar fibrous thickness and various lymphocyte infiltration. Immunotherapy-related OP was identified, and he subsequently responded well to corticosteroids. This case describes a clinical situation, where PD-1-induced OP is radiologically similar to NSCLC disease progression in the lungs. Oncologists should be aware of uncommon pulmonary PD-1/PD-L1 inhibitor toxicity. Lung biopsy may help to distinguish immune-related pneumonitis, lung infections, and progressive nodular lesions.
引用
收藏
页码:1555 / 1559
页数:5
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