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durvalumab 治疗非小细胞肺癌放化疗后结核病再激活:病例报告。

Reactivation of TB during administration of durvalumab after chemoradiotherapy for non-small-cell lung cancer: a case report.

机构信息

Department of Thoracic Oncology, Saitama Cancer Center, Saitama, Japan.

Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.

出版信息

Immunotherapy. 2020 Apr;12(6):373-378. doi: 10.2217/imt-2020-0061. Epub 2020 Apr 21.

Abstract

Tuberculosis (TB) is considered to be an adverse effect of treatment with immune checkpoint inhibitors. Our case was a 75-year-old woman diagnosed with unresectable stage III non-small-cell lung cancer. After radical chemoradiotherapy was completed, durvalumab was initiated as a consolidation therapy. However, since chest CT showed appearances of infiltration shadows scattered in the periphery of the lungs after five doses of immunotherapy, duruvalumab was discontinued. 6 weeks later, the patient was aware of intermittent fever. Chest CT scan showed the appearance of a tree-in-bud pattern in the right lung. Acid-fast bacilli stain of sputum was positive and the PCR test was positive for . Duruvalumab as PD-L1 blockade may activate TB.

摘要

结核病(TB)被认为是免疫检查点抑制剂治疗的不良反应。我们的病例是一位 75 岁女性,诊断为不可切除的 III 期非小细胞肺癌。根治性放化疗完成后,开始使用度伐鲁单抗作为巩固治疗。然而,由于胸部 CT 显示免疫治疗 5 剂后肺部周围出现浸润阴影,度伐鲁单抗被停用。6 周后,患者出现间歇性发热。胸部 CT 扫描显示右肺呈树芽征。痰抗酸杆菌染色阳性,PCR 检测 阳性。度伐鲁单抗作为 PD-L1 阻断剂可能激活 TB。

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