Mendiola Vincent Louie, Kesireddy Meghana, Jana Bagi
Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA.
Hematology/Oncology, University of Texas Medical Branch, Galveston, TX, USA.
Case Rep Oncol Med. 2019 Dec 26;2019:6759472. doi: 10.1155/2019/6759472. eCollection 2019.
Nivolumab, an antiprogrammed death-1 checkpoint inhibitor, has been approved for use in unresectable/metastatic renal cell carcinoma (RCC). Nivolumab-induced pneumonitis, a rare, but often severe and potentially life-threatening immune-related adverse event, has been reported, typically, early during the treatment. Due to its low incidence, more studies are needed to better elucidate this condition and its possible effects on cancer progression. We now present a 57-year-old Hispanic male patient with metastatic RCC-clear cell type who, after his 34 cycle of nivolumab (16 months after being on nivolumab), developed a late-onset, immune-related adverse event (IRAE) including a grade 3 pneumonitis, which resolved completely, clinically, and on serial lung imaging with steroids and drug discontinuation. His cancer remained stable with no progression for 18 months despite discontinuation of nivolumab which showed tumor progression resistance. This case report is aimed at providing further information regarding the rare phenomena of a late-onset IRAE, in particular, a grade 3 nivolumab-induced pneumonitis which also responded rapidly to treatment, as well as at discussing this immunotherapy's durable tumor suppressive effect and a possible associated factor to this phenomenon.
纳武单抗是一种抗程序性死亡-1检查点抑制剂，已被批准用于不可切除/转移性肾细胞癌（RCC）。据报道，纳武单抗引起的肺炎是一种罕见但通常严重且可能危及生命的免疫相关不良事件，通常在治疗早期出现。由于其发病率低，需要更多研究来更好地阐明这种情况及其对癌症进展的可能影响。我们现在介绍一名57岁的西班牙裔男性患者，患有转移性RCC透明细胞型，在接受纳武单抗治疗34个周期后（使用纳武单抗16个月后），出现了迟发性免疫相关不良事件（IRAE），包括3级肺炎，经类固醇治疗和停药后，临床症状及系列肺部影像学检查显示完全缓解。尽管停用了纳武单抗，但他的癌症在18个月内保持稳定，无进展，显示出肿瘤进展抗性。本病例报告旨在提供有关迟发性IRAE罕见现象的进一步信息，特别是3级纳武单抗引起的肺炎对治疗也有快速反应，并讨论这种免疫疗法的持久肿瘤抑制作用以及与此现象可能相关的因素。
