Department of Clinical Oncology, Tokyo Medical University Hachioji Medical Center, Tokyo, 193-0998, Japan.
Department of Hematology, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan.
BMC Pulm Med. 2018 Jan 30;18(1):23. doi: 10.1186/s12890-018-0592-x.
Nivolumab, an anti-programmed cell death-1 (PD-1) monoclonal antibody used as an immune checkpoint inhibitor, is commonly employed for its anti-tumor effects against various types of malignant tumors. However, its administration is complicated by immune-related adverse events (irAEs), including pneumonitis.
We present a case series of four patients with malignant melanoma, non-small cell lung cancer, and hypopharyngeal carcinoma who demonstrated pneumonitis induced by nivolumab, and further review clinicopathological characteristics of these patients in comparison with those of previously reported patients with nivolumab-induced pneumonitis. In our series, 20% of patients who were treated with nivolumab developed pneumonitis, all of which occurred approximately 2 weeks after the initiation of nivolumab treatment. Prompt recognition of the nivolumab-induced pneumonitis allowed for successful resolution. Computed tomography scan images of the patients demonstrated predominantly cryptogenic organizing pneumonia patterns. All patients were males, who had been heavily treated with antitumor drugs prior to nivolumab.
Our case series showed that nivolumab had a high incidence of drug-induced pneumonitis with early onset, supporting the need for renewed attention to nivolumab-induced pneumonitis, particularly in patients with a history of heavy antitumor treatments.
纳武利尤单抗（一种抗程序性死亡-1（PD-1）的单克隆抗体，作为免疫检查点抑制剂使用）因其对各种恶性肿瘤的抗肿瘤作用而被广泛应用。然而，其应用受到免疫相关不良反应（irAEs）的限制，包括肺炎。
我们报告了 4 例恶性黑色素瘤、非小细胞肺癌和下咽癌患者，这些患者因纳武利尤单抗引起肺炎，我们进一步比较了这些患者的临床病理特征与先前报道的纳武利尤单抗引起肺炎的患者。在我们的系列中，20%接受纳武利尤单抗治疗的患者发生了肺炎，所有肺炎均发生在纳武利尤单抗治疗开始后约 2 周。及时识别纳武利尤单抗诱导的肺炎可使其成功缓解。患者的计算机断层扫描图像显示主要为隐源性机化性肺炎模式。所有患者均为男性，在接受纳武利尤单抗治疗前接受了大量抗肿瘤药物治疗。
我们的病例系列表明，纳武利尤单抗引起的肺炎发生率较高，且发病较早，这支持对纳武利尤单抗诱导的肺炎重新引起重视，特别是在有大量抗肿瘤治疗史的患者中。
