scholarly journals Perforation of small intestinal metastasis of lung adenocarcinoma treated with pembrolizumab: a case report

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Shoki Sato ◽  
Naoto Senmaru ◽  
Keita Ishido ◽  
Takahiro Saito ◽  
Saseem Poudel ◽  
...  
Keyword(s):  
Cell Death ◽  
Side Effects ◽  
Programmed Cell Death ◽  
Lung Adenocarcinoma ◽  
Small Cell Lung Carcinoma ◽  
Bowel Perforation ◽  
Pathological Examination ◽  
Cell Lung Carcinoma ◽  
Small Intestinal ◽  
Intestinal Metastasis

Abstract Background Pembrolizumab is an immune checkpoint inhibitor and is an anti-human programmed cell death-1 (PD-1) monoclonal antibody. Pembrolizumab is used for non-small cell lung carcinoma with high programmed cell death ligand-1 (PD-L1) expression. It has been found that better overall survival can be obtained using pembrolizumab compared to the existing chemotherapy. We report a case of perforation of small intestinal metastasis after pembrolizumab treatment. Case presentation A 62-year-old man was treated by pembrolizumab for PD-L1 highly expressed lung adenocarcinoma, with multiple metastasis (small intestinal, lymph nodes, and bone). The treatment was stopped owing to drug-induced pneumonitis. One month after drug withdrawal, the patient visited the emergency department of our hospital with the complaint of severe stomachache. He had a rigid abdomen and generalized tenderness, and computed tomography scans showed free air within the abdomen. We diagnosed bowel perforation and performed emergency surgery. Surgical findings revealed multiple small intestine metastasis and mesenteric lymph node metastasis. Perforation was found in the metastatic site in the jejunum located around 40 cm anal to Treitz’s ligament. This perforated part was resected, and functional end-to-end anastomosis was performed using linear staplers. The post-operative course was uneventful. Pathological examination revealed lung adenocarcinoma metastasis at the perforation site, and the effectiveness of pembrolizumab was grade 1b (Japanese Classification of the Colorectal Carcinoma, seventh edition). Conclusions This is the first report of perforation of small intestinal metastasis of lung adenocarcinoma after pembrolizumab treatment. Because pembrolizumab causes some side effects, particularly autoimmune side effects, careful attention during treatment is warranted.

Side effects of immune-checkpoint inhibitors: Can multiple side effects be seen in a patient?

2021 ◽  
pp. 107815522110381
Author(s):  
Esra Özyurt ◽  
Serhat Özçelik ◽  
Heves Sürmeli ◽  
Mehmet Çelik ◽  
Murat Ayhan ◽  
...  
Keyword(s):  
T Cells ◽  
Cell Death ◽  
Side Effects ◽  
Programmed Cell Death ◽  
Adverse Events ◽  
Checkpoint Inhibitors ◽  
Host Cells ◽  
Immunoglobulin G4 ◽  
Programmed Cell Death 1 ◽  
Recurrent Renal Cell Carcinoma

Introduction Nivolumab is a human immunoglobulin G4 monoclonal antibody that inhibits programmed cell death-1 activity by binding to the programmed cell death-1 receptors. Cancer cells express increased number of programmed cell death-1 ligands and this allows them to escape the cytotoxic effects of the T cells. Therefore, the negative programmed cell death-1 receptor signal regulates T-cell proliferation and activation is disrupted. However, this change in the activity of the T cells can cause them to lose their ability to recognize host cells. The immune response enabled by these agents has led to side effects, commonly known as “immune-related adverse events.” Case report We report a case of a 66-year-old male patient who was treated with nivolumab for recurrent renal cell carcinoma presented with hepatitis and adrenalitis. Three weeks after starting nivolumab, the patient had abdominal pain and weakness, and then aspartate and alanine transaminase levels were found to be elevated. Management and outcome Hepatitis was predicted to be due to nivolumab, because other causes were excluded. He started using oral methylprednisolone and then, hepatitis improved. However, while receiving methylprednisolone treatment, fludrocortisone was started with the pre-diagnosis of adrenalitis due to the persistence of fatigue, weakness, and hyponatremia and hyperkalemia. With both treatments, the patient's symptoms and sodium and potassium level returned to normal. Discussion This case emphasizes the need for patient's education and awareness of immune-related adverse events, and the importance of understanding the management of life-threatening complications of the checkpoint inhibitors, because these side effects require prompt recognition and treatment.

CircRNAs in lung adenocarcinoma: diagnosis and therapy

2021 ◽  
Vol 21 ◽  
Author(s):  
Lijia Su ◽  
Jinying Zhao ◽  
Huahua Su ◽  
Yanhua Wang ◽  
Wenfeng Huang ◽  
...  
Keyword(s):  
Lung Adenocarcinoma ◽  
Biomedical Application ◽  
Small Cell Lung Carcinoma ◽  
Disease Diagnosis ◽  
Circular Rnas ◽  
Cell Lung Carcinoma ◽  
Diagnosis And Therapy ◽  
Diagnosis And Prognosis ◽  
Novel Biomarkers ◽  
New Biomarkers

: Lung adenocarcinoma (LUAD) is the common histological subtype of non-small-cell lung carcinoma (NSCLC). Circular RNAs (circRNAs) represent a new class of non-coding RNAs (ncRNAs) involved in the development of cancer. Accumulating evidence indicated that a large number of circular RNAs were found to be involved in many biological processes, including tumor initiation, proliferation and progression. These circRNAs present great potentials as new biomarkers and vital targets for disease diagnosis and prognosis. In this review, we mainly focus on the differentially expressed circRNAs and their functions in the pathogenesis of LUAD, which makes it possible for the utility of circRNAs as novel biomarkers for early diagnosis and therapy. Especially, it is helpful to develop circRNAs as crucial therapeutic targets, thus providing a promising biomedical application in the field of cancer gene therapy.

scholarly journals The significance of programmed cell death ligand 1 expression in resected lung adenocarcinoma

Oncotarget ◽  
2017 ◽  
Vol 8 (10) ◽  
pp. 16421-16429 ◽  
Author(s):  
Shafei Wu ◽  
Xiaohua Shi ◽  
Jian Sun ◽  
Yuanyuan Liu ◽  
Yufeng Luo ◽  
...  
Keyword(s):  
Cell Death ◽  
Programmed Cell Death ◽  
Lung Adenocarcinoma

scholarly journals A UNIQUE CASE OF ATEZOLIZUMAB-INDUCED AUTOIMMUNE DIABETES

2020 ◽  
Vol 6 (1) ◽  
pp. e30-e32
Author(s):  
Mimi Wong ◽  
Nirjhar Nandi ◽  
Ashim Sinha
Keyword(s):  
Cell Death ◽  
Programmed Cell Death ◽  
Autoimmune Diabetes ◽  
Case Reports ◽  
Zinc Transporter ◽  
Prior History ◽  
Unique Case ◽  
Cell Lung Carcinoma ◽  
Zinc Transporter 8 ◽  
First Case

Objective: Immunotherapy is a novel treatment that can cause autoimmune diabetes in rare cases. More cases occur following use of the inhibitor to the protein programmed cell death-1 rather than the inhibitor to programmed cell death-ligand 1. Methods: We report a unique case of autoimmune diabetes following atezolizumab use. Results: A 55-year-old, Aboriginal Australian female with no prior history of diabetes was commenced on atezolizumab for recurrent squamous cell lung carcinoma. Two months following its commencement, there was the onset of fatigue, polyuria, polydipsia, and new hyperglycemia. Subsequently she was found to have a borderline-low C peptide level of 0.6 nmol/L (reference range is 0.5 to 1.0 nmol/L), and positive zinc transporter-8 antibodies. Following the diagnosis of autoimmune diabetes, 5 units of glargine insulin was commenced which maintained euglycemia and resolved her symptoms of hyperglycemia. Conclusion: There are few case reports of atezolizumab-induced autoimmune diabetes. We present the first case associated with zinc transporter-8 antibodies, and a unique case of autoimmune diabetes in a patient of Aboriginal Australian background.

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