Department of Radiation Oncology, University Hospital, LMU Munich.
Comprehensive Pneumology Center Munich (CPC-M), Munich, Germany.
J Immunother. 2018 Feb/Mar;41(2):96-99. doi: 10.1097/CJI.0000000000000198.
Nivolumab is a feasible therapy option in patients with advanced non-small cell lung cancer (NSCLC) who progress on first-line treatment. However, there is limited information about an overlapping toxicity of PD-1 inhibitors when administered following thoracic radiotherapy (TRT). Three of 25 patients with advanced NSCLC were treated with palliative or curative intent. Nivolumab was initiated as second or third-line therapy after TRT for recurrent or progressive disease. All 3 patients developed grade 3 pneumonitis at some point during nivolumab therapy. Herein, we describe 3 cases of pneumonitis in patients with NSCLC started on nivolumab following TRT. Imaging analysis was strongly consistent with heterogenous lung parenchyma changes in the irradiated lung volume receiving a total dose of 15-20 Gy. Pulmonary toxicity was manageable; however, interruption of immunotherapy was necessary.
纳武利尤单抗是一线治疗后进展的晚期非小细胞肺癌（NSCLC）患者的一种可行治疗选择。然而，关于 PD-1 抑制剂在接受胸部放射治疗（TRT）后重叠毒性的信息有限。25 名晚期 NSCLC 患者中有 3 名接受姑息或根治性治疗。纳武利尤单抗在 TRT 后用于复发性或进行性疾病的二线或三线治疗。所有 3 名患者在接受纳武利尤单抗治疗期间的某个时间点均出现 3 级肺炎。在此，我们描述了 3 例在接受 TRT 后开始使用纳武利尤单抗的 NSCLC 患者的肺炎病例。影像学分析强烈提示与接受 15-20Gy 总剂量照射的肺体积中不均匀的肺实质变化一致。肺毒性可控制，但需要中断免疫治疗。
