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A case report of immune-related pneumonitis after combined treatment of non small cell lung cancer

https://doi.org/10.21518/2079-701X-2020-9-258-264

Abstract

Immunotherapy is the most promising method in the treatment of lung cancer, especially in connection with the rapidly growing development of monoclonal antibodies aimed at inhibiting immune checkpoints: anti-CTLA-4, anti-PD-1, anti-PD-L1. Classic immuno-mediated adverse events that occur with this method of treatment can affect several organs, including the lungs. Pneumonitis is a potentially life-threatening complication and often requires rapid treatment with high doses of corticosteroids and antibacterial drugs.
We present the case of a 67-year-old patient with primary multiple malignant tumors of the larynx and left lung after combined treatment and incomplete treatment with Nivolumab, complicated by immuno-mediated pneumonitis.
This report highlights the importance of treating patients with contraindications to chemotherapy when specific antitumor treatment is required, as well as timely detection of a rare but dangerous adverse event: immuno-mediated pneumonitis that occurs during treatment with immune checkpoint inhibitors.
Thus, knowing the frequency of adverse events when using PD-1 and PD-L1 inhibitors, as well as the possible presence of comorbidities in patients, will make it easier for doctors to make informed decisions in the treatment of patients, and understanding the interaction of the tumor and the immune system will help determine the best predictors of response and further improve the results of treatment of patients with NSCLC.

About the Authors

E. S. Denisova
N.N. Blokhin National Medical Research Center of Oncology; First Moscow State Medical University named after I.M. Sechenov (Sechenov University)
Russian Federation

Elena S. Denisova, Resident of the Department of Medicinal Treatment Methods (Chemotherapeutic No. 17); resident of the Department of Oncology of the Medical Facultyclkk

24, Kashirskoye Shosse, Moscow, 115478

8, Bldg. 2, Trubetskaya St., Moscow, 119991



M. S. Ardzinba
N.N. Blokhin National Medical Research Center of Oncology
Russian Federation

Merab S. Ardzinba, Cand. of Sci. (Med), Oncologist, Oncological Department of Medicinal Methods of Treatment (Chemotherapeutic No. 17)

24, Kashirskoye Shosse, Moscow, 115478 



K. K. Laktionov
N.N. Blokhin National Medical Research Center of Oncology; Pirogov Russian National Research Medical University
Russian Federation

Konstantin K. Laktionov, Dr. of Sci. (Med), Professor of the Department of Oncology and Radiation Therapy of the Faculty of Medicine; Head of the Oncological Department of Medical Treatment Methods (Chemotherapeutic No. 17)

24, Kashirskoye Shosse, Moscow, 115478

1, Ostrovityanov St., Moscow, 117997

 



D. I. Yudin
N.N. Blokhin National Medical Research Center of Oncology
Russian Federation

Denis I. Yudin, Cand. of Sci. (Med.), senior researcher

24, Kashirskoye Shosse, Moscow, 115478 



K. A. Sarantseva
N.N. Blokhin National Medical Research Center of Oncology
Russian Federation

Ksenia A. Sarantseva, Cand. of Sci. (Med), Oncologist

24, Kashirskoye Shosse, Moscow, 115478 



G. V. Shcherbakova
First Moscow State Medical University named after I.M. Sechenov (Sechenov University)
Russian Federation

Galina V. Shcherbakova, Cand. of Sci. (Med.), Associate Professor, Phthisiatrist, Pulmonologist, Department of Phthisiopulmonology and Thoracic Surgery named after M.I. Perelman

8, Bldg. 2, Trubetskaya St., Moscow, 119991



N. V. Marinichenko
N.N. Blokhin National Medical Research Center of Oncology
Russian Federation

Nataliya V. Marinichenko, Postgraduate student of the Department of Medicinal Treatment Methods (Chemotherapeutic No. 17); Resident of the Department of Oncology of the Medical Faculty

24, Kashirskoye Shosse, Moscow, 115478 



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Review

For citations:


Denisova ES, Ardzinba MS, Laktionov KK, Yudin DI, Sarantseva KA, Shcherbakova GV, Marinichenko NV. A case report of immune-related pneumonitis after combined treatment of non small cell lung cancer. Meditsinskiy sovet = Medical Council. 2020;(9):258-264. (In Russ.) https://doi.org/10.21518/2079-701X-2020-9-258-264

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