Deng Peng-Bo, Jiang Juan, Hu Cheng-Ping, Cao Li-Ming, Li Min
Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Diseases, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China.
World J Clin Cases. 2022 Feb 16;10(5):1580-1585. doi: 10.12998/wjcc.v10.i5.1580.
Cytokine release syndrome (CRS) is defined as systemic inflammation that usually occurs following chimeric antigen receptor T-cell therapy administration; however, it has not been reported in patients with untreated non-small cell lung cancer to date.
A 44-year-old nonsmoking woman presented to the hospital due to fever, palpitation, nausea, and cough for 1 mo and was diagnosed with stage cT3N3M0 (IIIc) adenocarcinoma of the lung. Auxiliary examinations revealed elevated cytokine [tumor necrosis factor-α, interleukin (IL)-1β, and IL-6] and inflammatory factor levels, which decreased after treatment with corticosteroids and immunoglobulin and when tumor growth was controlled following chemotherapy, radiotherapy, and antiangiogenesis therapy. However, tumor recurrence was observed. After administration of nivolumab as third-line treatment, the patient's condition was transiently controlled; however, CRS-like symptoms suddenly emerged, which led to a resurgence of cytokines and inflammatory factors and rapid death.
CRS can develop in treatment-naïve lung cancer patients. Patients with tumor-related CRS may be at risk of CRS recurrence, aggravation, and onset of immune checkpoint inhibitor-related adverse events.
细胞因子释放综合征（CRS）被定义为通常在嵌合抗原受体T细胞疗法给药后发生的全身炎症；然而，迄今为止，未经治疗的非小细胞肺癌患者中尚未有相关报道。
一名44岁不吸烟女性因发热、心悸、恶心和咳嗽1个月入院，被诊断为肺cT3N3M0（IIIc期）腺癌。辅助检查显示细胞因子[肿瘤坏死因子-α、白细胞介素（IL）-1β和IL-6]和炎症因子水平升高，在使用皮质类固醇和免疫球蛋白治疗后以及化疗、放疗和抗血管生成治疗控制肿瘤生长后这些水平下降。然而，观察到肿瘤复发。在给予纳武单抗作为三线治疗后，患者病情得到短暂控制；然而，类似CRS的症状突然出现，导致细胞因子和炎症因子再次升高并迅速死亡。
未接受过治疗的肺癌患者可能发生CRS。患有肿瘤相关CRS的患者可能有CRS复发、加重以及发生免疫检查点抑制剂相关不良事件的风险。
