Giant cell arteritis associated with PD-1 inhibition

2021 ◽  
Vol 14 (11) ◽  
pp. e246443
Author(s):  
Nina Couette ◽  
Jisna Paul
Keyword(s):  
Malignant Disease ◽  
Temporal Artery ◽  
Steroid Treatment ◽  
Antagonist Therapy ◽  
Programmed Death ◽  
Metastatic Lung ◽  
History Of ◽  
Steroid Side Effects ◽  
Programmed Death 1 ◽  
New Onset

A 50-year-old woman was referred to rheumatology for new onset polyarthralgia and headache. She had a history of metastatic lung adenocarcinoma and was started on treatment with the programmed death 1 receptor (PD-1) antagonist pembrolizumab 2 months prior. Examination revealed left temporal artery tenderness and hand synovitis. Investigations revealed enlarged temporal artery on ultrasound imaging. On steroid treatment, she had resolution of symptoms, but due to significant steroid side effects required methotrexate and her PD-1 antagonist therapy was continued in consultation with her oncologist. Her malignant disease has remained stable, and she has improved functional status.

scholarly journals A case report of psoriasis flare following immunotherapy: Report of an important entity and literature review

2020 ◽  
Vol 8 ◽  
pp. 2050313X1989770 ◽  
Author(s):  
Anastasia Politi ◽  
Dimas Angelos ◽  
Davide Mauri ◽  
George Zarkavelis ◽  
George Pentheroudakis
Keyword(s):  
Adverse Events ◽  
Cytotoxic T Lymphocyte ◽  
Checkpoint Inhibitors ◽  
Skin Lesions ◽  
Inflammatory Disorder ◽  
Immune Mediated ◽  
Programmed Death ◽  
History Of ◽  
Programmed Death 1 ◽  
Cessation Of Treatment

Immune checkpoint inhibitors, such as anti-cytotoxic T-lymphocyte–associated antigen-4 and anti-programmed death-1, are a type of cancer immunotherapy approved for late-stage malignancy treatment. However, such therapies often induce immune-related adverse events. During anti-programmed death-1 blockade therapy, the most commonly reported adverse effects are skin toxicities, such as psoriasis—a chronic immune-mediated inflammatory disorder affecting the skin. We present the clinical characteristics of flared psoriasis in one patient under anti-programmed death-1 therapy who was diagnosed with T2N2M0/IIIB squamous lung carcinoma with a history of psoriasis for the past 5 years, exacerbated after the first cycle of nivolumab. After the third cycle, the extensive skin plaques necessitated treatment cessation. Following the discontinuation of anti-programmed death-1 treatment, skin lesions were treated locally. Possibly, anti-programmed death-1 immunotherapy can trigger immune-mediated diseases, such as psoriasis. Physicians should be alert to immune-related adverse events. Continuation or permanent cessation of treatment depends on the severity and reversibility of immune-related adverse events.

New-onset toxicity with programmed death-1 inhibitor rechallenge

2016 ◽  
Vol 26 (3) ◽  
pp. 316-318 ◽  
Author(s):  
Steven P. Ludlow ◽  
Stephanie Andrews ◽  
Yanina Pasikhova ◽  
Eboné Hill
Keyword(s):  
Programmed Death ◽  
Programmed Death 1 ◽  
New Onset

scholarly journals Sa1157 Normal Programmed Death-1 Expression in Peripheral Blood T-Cells, but Not Monocytes in Children With New Onset Crohn Disease

2014 ◽  
Vol 146 (5) ◽  
pp. S-215
Author(s):  
Hector Granados ◽  
Andrew Draghi ◽  
Francisco A. Sylvester ◽  
Anthony Vella
Keyword(s):  
T Cells ◽  
Crohn Disease ◽  
Peripheral Blood ◽  
Programmed Death ◽  
Programmed Death 1 ◽  
New Onset

Incidence, patterns of progression and outcomes of melanoma brain metastasis (MBM) during programmed-death 1 inhibitor (PD1i) therapy.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 9532-9532
Author(s):  
Gustavo Schvartsman ◽  
Junsheng Ma ◽  
Roland L. Bassett ◽  
Lauren Elaine Haydu ◽  
Rodabe Navroze Amaria ◽  
...  
Keyword(s):  
Cox Regression ◽  
Lung Metastases ◽  
Risk Of Death ◽  
Programmed Death ◽  
Increased Risk ◽  
Current Therapies ◽  
History Of ◽  
Programmed Death 1 ◽  
Frequent Site ◽  
Md Anderson

9532 Background: MBM are common in patients (pts) with metastatic melanoma (MM) and represent a frequent site of treatment failure with current therapies. Little is known, however, about the incidence, patterns of progression and outcomes of MBM pts treated with PD1i and in conjunction with central nervous system (CNS) focused therapy. Methods: Outcomes of mm pts treated with PD1i at MD Anderson from 01/12 to 07/16 were reviewed. The association between clinical variables and development of MBM and overall survival (OS) were assessed using logistic regression and Cox regression analyses. Results: We identified 324 mm pts, including 77 pts (24%) who had MBM prior to first dose of PD1i. Median follow-up from start of therapy was 16.3 months, median OS for pts without MBM at the start of PD1i 3.37 years, as compared to 2.85 years in pts with prior MBM (p = 0.268). Of the 247 pts without prior MBM, 64 (26%) developed MBM after exposure to PD1i. Of those, 21 pts (8.5%) developed MBM during therapy or within 30 days of discontinuation, with 12 (4.5%) having CNS-only progression, while 9 (3.6%) had both systemic and CNS progression. Pts with MBM prior to PD1i (n = 77) had CNS-only progression in 22 pts (28.6%) during therapy. Progression occurred in systemic and systemic plus CNS in 12 pts (15.6%) and 19 pts (24.7%), respectively. 24 pts (31.2%) had stable disease (SD). On multivariate analysis, pts with lung metastases (OR, 2.16; 95% CI, 1.25 - 3.78; p = 0.006) and NRAS-mutated tumors (OR, 2.17; 95% CI, 1.14 - 4.18; p = 0.02) were more likely to develop MBM; pts who had liver metastases at the start of PD1i (HR, 1.77; 95% CI, 1.09 - 2.87; p = 0.002) and those who developed MBM during PD1i (HR, 4.81; 95% CI, 3.00 - 7.71; p < 0.0001) had increased risk of death. Conclusions: We found a 26% incidence of MBM after PD1i exposure. Pts that develop MBM are still at higher risk of death despite advances in systemic and local CNS therapy. CNS-only progression was substantially higher in patients with MBM prior to PD1i, supporting a change in the natural history of the disease after PD1i. These findings support the use of CNS imaging to monitor disease during PD1i therapy.

scholarly journals PD-1: Its Discovery, Involvement in Cancer Immunotherapy, and Beyond

Cells ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. 1376 ◽  
Author(s):  
Yasumasa Ishida
Keyword(s):  
Immune System ◽  
Cancer Immunotherapy ◽  
Nobel Prize ◽  
Potential Role ◽  
Review Article ◽  
Orchestral Music ◽  
Concert Hall ◽  
Programmed Death ◽  
History Of ◽  
Programmed Death 1

On December 10, 2018, I was sitting among the big crowd of audience, as one of the invited guests to the ceremony, in the Stockholm Concert Hall. When King of Sweden Carl XVI Gustaf bestowed the diploma and medal of Nobel Prize of Physiology or Medicine 2018 on Dr. Tasuku Honjo and shook his hand for a while, surrounded by the thunderous applause and energetically blessing orchestral music, I thought that it had been a long journey for the molecule that we had first isolated in the early 1990s. Although it was truly a commemorable moment in the history of the programmed death-1 (PD-1) research, I believe we still have a long way to go. In this review article, I will explain why I think so, particularly by focusing on the potential role(s) that PD-1 appears to play in self-nonself discrimination by the immune system.

Risk factors for and characteristics of pneumonitis in patients treated with anti-programmed death-1 therapy.

2018 ◽  
Vol 36 (5_suppl) ◽  
pp. 128-128
Author(s):  
YI HU ◽  
Pengfei Cui ◽  
Jing Zhang
Keyword(s):  
Risk Factors ◽  
Combination Therapy ◽  
Clinical Features ◽  
Steroid Therapy ◽  
Low Grade ◽  
Thoracic Radiotherapy ◽  
Programmed Death ◽  
Lung Condition ◽  
History Of ◽  
Programmed Death 1

128 Background: Pneumonitis is an uncommon but potentially fatal toxicity of anti–programmed death-1 (PD-1) monoclonal antibodies (mAbs), but its prevalence, risk factors and clinical features are poorly described. Methods: The medical records of 234 patients with advanced cancer who underwent anti–PD-1mAbs therapies between September 2015 and September 2017 at the Cancer Center of the Chinese PLA (People’s Liberation Army) General Hospital were analyzed with regard to patient background and clinical features. Pneumonitis was diagnosed by the treating investigator; cases with confirmed malignant lung infiltration or infection were excluded. Univariate and multivariate analyses were performed to identify independent predictive factors for pneumonitis. Clinical features, management and prognosis of pneumonitis were also collected. Results: A total of 55 patients (23.5%) developed pneumonitis. Anti–PD-1mAbs induced pneumonitis was significantly associated with male sex, a history of prior thoracic radiotherapy, combination therapy and underlying lung condition (odds ratios 3.380, 3.081, 2.538 and 2.559, respectively). Time to onset of pneumonitis ranged from 2 days to 277days (median time was 85days). 85.4% (47 of 55) of cases were grade 1 to 2, 25.5% (14 of 55) were treated with steroid therapy, of which 85.7% (12 of 14) resolved/ improved. Nine (16.4%) patients worsened clinically and one died during the course of pneumonitis treatment. Conclusions: Pneumonitis associated with anti–PD-1 mAbs is a serious adverse effect in the clinical setting that cannot be ignored. However, patient selection based on sex, history of prior thoracic radiotherapy, combination therapy and underlying lung condition can minimize pneumonitis risk. Most events are low grade and resolved/ improved with steroid therapy. Rarely, pneumonitis worsens despite steroid therapy, and may result in death.

scholarly journals PD-L1

2017 ◽  
Vol 71 (3) ◽  
pp. 189-194 ◽  
Author(s):  
Anthousa Kythreotou ◽  
Abdul Siddique ◽  
Francesco A Mauri ◽  
Mark Bower ◽  
David J Pinato
Keyword(s):  
Immune Cell ◽  
Cell Activity ◽  
Predictive Biomarker ◽  
Tumour Regression ◽  
Tissue Destruction ◽  
Immune Evasion Mechanism ◽  
Programmed Death ◽  
Metastatic Lung ◽  
Programmed Death 1 ◽  
Contradictory Evidence

Programmed death ligand 1 (PD-L1) is the principal ligand of programmed death 1 (PD-1), a coinhibitory receptor that can be constitutively expressed or induced in myeloid, lymphoid, normal epithelial cells and in cancer. Under physiological conditions, the PD-1/PD-L1 interaction is essential in the development of immune tolerance preventing excessive immune cell activity that can lead to tissue destruction and autoimmunity. PD-L1 expression is an immune evasion mechanism exploited by various malignancies and is generally associated with poorer prognosis. PD-L1 expression is also suggested as a predictive biomarker of response to anti-PD-1/PD-L1 therapies; however, contradictory evidence exists as to its role across histotypes. Over the years, anti-PD-1/PD-L1 agents have gained momentum as novel anticancer therapeutics, by inducing durable tumour regression in numerous malignancies including metastatic lung cancer, melanoma and many others. In this review, we discuss the immunobiology of PD-L1, with a particular focus on its clinical significance in malignancy.

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