Programmed cell death 1 blockade-induced cutaneous sarcoid-like epithelioid granulomas in advanced melanoma: a case report

Multiple gene-driven programmed cell death 1 ligand 1 (PD-L1)-expressing non-small-cell lung cancer (NSCLC) is very rare. Previous studies have shown that patients with NSCLC with anaplastic lymphoma kinase (ALK) gene rearrangement rarely benefit from PD-L1 inhibitors. Besides the secondary mutations in ALK gene, other mechanisms might contribute to tumor resistance to ALK tyrosine kinase inhibitors (ALK-TKIs). Herein, we present a case of PD-L1-overexpressing lung adenocarcinoma that harbors both EML4-ALK gene rearrangement and BRAF mutation. In particular, a second molecular analysis after resistance to first- and second-generation ALK-TKIs revealed a high PD-L1 expression and tumor mutation burden. Therefore, treatment with nivolumab monotherapy, an anti-PD-1 inhibitor, was started and the patient achieved complete remission. This case report suggested that PD-1 inhibitors might be an effective treatment option for patients with multiple gene-driven PD-L1-expressing NSCLC harboring ALK gene rearrangement.

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The Efficacy and Safety of Programmed Cell Death 1 and Programmed Cell Death 1 Ligand Inhibitors for Advanced Melanoma

Medicine ◽

10.1097/md.0000000000003134 ◽

2016 ◽

Vol 95 (11) ◽

pp. e3134 ◽

Cited By ~ 8

Author(s):

Xiuwen Guan ◽

Haijuan Wang ◽

Fei Ma ◽

Haili Qian ◽

Zongbi Yi ◽

...

Keyword(s):

Cell Death ◽

Programmed Cell Death ◽

Advanced Melanoma ◽

Efficacy And Safety ◽

Programmed Cell Death 1

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Association of Anti–Programmed Cell Death 1 Cutaneous Toxic Effects With Outcomes in Patients With Advanced Melanoma

JAMA Oncology ◽

10.1001/jamaoncol.2019.0046 ◽

2019 ◽

Vol 5 (6) ◽

pp. 906 ◽

Cited By ~ 25

Author(s):

Henry T. Quach ◽

Anna K. Dewan ◽

Elizabeth J. Davis ◽

Kristin K. Ancell ◽

Run Fan ◽

...

Keyword(s):

Cell Death ◽

Programmed Cell Death ◽

Advanced Melanoma ◽

Toxic Effects ◽

Programmed Cell Death 1

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A Case Report of Graves’ Disease Induced by the Anti-Human Programmed Cell Death-1 Monoclonal Antibody Pembrolizumab in a Bladder Cancer Patient

Case Reports in Endocrinology ◽

10.1155/2019/2314032 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5

Author(s):

Ken Yajima ◽

Yushi Akise

Keyword(s):

Monoclonal Antibody ◽

Bladder Cancer ◽

Cell Death ◽

Case Report ◽

Programmed Cell Death ◽

Thyroid Function ◽

Superior Thyroid Artery ◽

Graves Disease ◽

Bladder Cancer Patient ◽

Programmed Cell Death 1

Immune checkpoint inhibitors, such as anti-programmed cell death-1 (anti-PD-1), have been widely used in the treatment of malignancies. However, these drugs can cause immune-related adverse events resembling autoimmune diseases. There are some reports of Graves’ disease (GD) induced by anti-cytotoxic T-lymphocyte-associated antigen 4 antibodies, but reports which discussed GD induced by anti-PD-1 antibodies are very rare. We report the case of a 61-year-old man with bladder cancer who presented with severe diarrhea, fatigue, palpitation, body weight loss, and hyperthyroidism after the fifth treatment with the anti-PD-1 monoclonal antibody pembrolizumab. His thyroid function prior to pembrolizumab administration had been subclinical hyperthyroidism, despite a negative thyroid-stimulating hormone receptor antibody (TRAb) level. On admission, pembrolizumab administration was discontinued. Graves’ disease was diagnosed based on a positive TRAb test result and the ultrasonographic finding of increased blood flow in the superior thyroid artery. Based on colonoscopy findings, the cause of diarrhea was diagnosed as active colitis. His diarrhea was improved with prednisolone, and thyroid function was treated with potassium iodide and thiamazole. This case report of GD with positive TRAb induced by the anti-PD-1 antibody pembrolizumab may contribute to the understanding of the mechanism underlying the association between GD and autoimmune activation via PD-1.

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