scholarly journals Case Report: Durvalumab-Associated Encephalitis in Extensive-Stage Small Cell Lung Carcinoma

2021 ◽  
Vol 11 ◽  
Author(s):  
Yosuke Shionoya ◽  
Akito Hattori ◽  
Taro Hanada ◽  
Michihiro Fujino
Keyword(s):  
Checkpoint Inhibitors ◽  
Small Cell Lung Carcinoma ◽  
Pulse Therapy ◽  
Small Cell ◽  
Steroid Pulse Therapy ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma ◽  
Steroid Pulse ◽  
Cell Counts ◽  
Extensive Stage

In recent years, the clinical importance of immunotherapy has been demonstrated in the treatment of extensive-stage small-cell lung cancer (ES-SCLC). However, immune checkpoint inhibitors (ICIs) have been shown to cause immune-related adverse events (irAEs), including autoimmune encephalitis. Here, we describe th treatment of a patient with ES-SCLC who developed immune-related encephalitis. A 68-year-old Japanese woman with ES-SCLC treated with carboplatin plus etoposide plus durvalumab 20 days earlier was admitted to our hospital with a high fever and anorexia. Her symptoms gradually worsened over time, and she had a headache daily and showed reduced levels of consciousness. An electroencephalogram showed diffuse slow waves, and there was a slight increase in cell counts and an increase in protein levels in the cerebrospinal fluid. The patient was diagnosed with durvalumab-associated encephalitis. Her symptoms improved immediately after steroid pulse therapy. Following steroid pulse therapy, oral prednisolone (1 mg/kg) was administered, and then, the dose was gradually reduced. Subsequently, treatment with carboplatin plus etoposide without durvalumab was restarted. In conclusion, this study shows the efficacy of steroid therapy in the treatment of durvalumab-induced encephalitis in ES-SCLC.

scholarly journals Optic Neuritis Possibly Induced by Anti-PD-L1 Antibody Treatment in a Patient with Non-Small Cell Lung Carcinoma

2018 ◽  
Vol 9 (2) ◽  
pp. 348-356 ◽  
Author(s):  
Sotaro Mori ◽  
Takuji Kurimoto ◽  
Kaori Ueda ◽  
Hiroko Enomoto ◽  
Mari Sakamoto ◽  
...  
Keyword(s):  
Optic Neuritis ◽  
Lung Carcinoma ◽  
Small Cell Lung Carcinoma ◽  
Pulse Therapy ◽  
Small Cell ◽  
Steroid Pulse Therapy ◽  
Small Cell Lung ◽  
Antibody Treatment ◽  
Cell Lung Carcinoma ◽  
Steroid Pulse

Background: Recent immune therapy with checkpoint inhibitors (CPIs) has demonstrated remarkable antitumor effects on specific tumors, such as malignant lymphoma and non-small cell lung carcinoma. By contrast, CPIs cause an imbalance in the immune system, triggering a wide range of immunological side effects termed immune-related adverse effects (irAEs). Here, we report a rare case of optic neuritis and hypopituitarism during anti-programmed death-ligand 1 (PD-L1) antibody treatment. Case Presentation: A patient with non-small cell lung carcinoma received anti-PD-L1 antibody treatment every 3 weeks; however, the patient started experiencing headaches, general fatigue, anorexia, and diarrhea approximately 1 year after the initiation of the treatment. Moreover, sudden visual loss of the right eye occurred 1 week after the interruption of the anti-PD-L1 antibody treatment. MRI findings showed gadolinium enhancement in the left optic nerve, but no enlargement of the pituitary gland and stalk. Laboratory data showed decreased serum adrenocorticotropic hormone (ACTH), cortisol, and free T4 levels, and a hormone tolerance test indicated hypopituitarism, hypothyroidism, and hypoadrenocorticism. The central scotoma caused by optic neuritis completely disappeared immediately after a course of steroid pulse therapy, and no recurrence occurred up to 2 years after initiation of the steroid pulse therapy while replacement therapy for hypothyroidism and hypoadrenocorticism was continued. Conclusions: The patient presented with optic neuritis and hypopituitarism, possibly due to irAEs of the anti-PD-L1 antibody treatment. Steroid pulse therapy was effective for optic neuritis, suggesting underlying immunological mechanisms. Neurological complications including optic neuritis should be considered when examining patients with cancer undergoing CPI treatment.

scholarly journals Immunocheckpoint Inhibitor- (Nivolumab-) Associated Hypereosinophilia in Non-Small-Cell Lung Carcinoma

2020 ◽  
Vol 2020 ◽  
pp. 1-5 ◽  
Author(s):  
Navdeep Singh ◽  
Sandeep Singh Lubana ◽  
George Constantinou ◽  
Andrea N. Leaf
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Lung Carcinoma ◽  
Cell Lung Cancer ◽  
Checkpoint Inhibitors ◽  
Small Cell Lung Carcinoma ◽  
Small Cell ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma ◽  
Eosinophil Counts

Immunocheckpoint inhibitor (ICI) therapy has provided significant clinical improvements in the treatment of several malignancies. The purpose of this report is to increase awareness of hypereosinophilia associated with checkpoint inhibitors, a topic that has been rarely reported. Hypereosinophilia may need to be addressed especially if eosinophil counts increase to levels where hypereosinophilic visceral complications can occur. We are presenting a case of a 57-year-old male with hypereosinophilia that was seen in the setting of progression of metastatic non-small-cell lung cancer during and after nivolumab treatment.

scholarly journals Liquid Biopsy Biomarkers for Immunotherapy in Non-Small Cell Lung Carcinoma: Lessons Learned and the Road Ahead

2021 ◽  
Vol 11 (10) ◽  
pp. 971
Author(s):  
Jesus Hita-Millan ◽  
Angel Carracedo ◽  
Ceres Fernandez-Rozadilla
Keyword(s):  
Liquid Biopsy ◽  
Checkpoint Inhibitors ◽  
Small Cell Lung Carcinoma ◽  
Significant Proportion ◽  
Small Cell ◽  
Lessons Learned ◽  
Small Cell Lung ◽  
Secondary Resistance ◽  
Cell Lung Carcinoma ◽  
The Road

Over the recent years, advances in the development of anti-cancer treatments, particularly the implementation of ICIs (immune checkpoint inhibitors), have resulted in increased survival rates in NSCLC (non-small cell lung cancer) patients. However, a significant proportion of patients does not seem respond to immunotherapy, and some individuals even develop secondary resistance to treatment. Therefore, it is imperative to correctly identify the patients that will benefit from ICI therapy in order to tailor therapeutic options in an individualised setting, ultimately benefitting both the patient and the health system. Many different biomarkers have been explored to correctly stratify patients and predict response to immunotherapy, but liquid biopsy approaches have recently arisen as an interesting opportunity to predict and monitor treatment response due to their logistic accessibility. This review summarises the current data and efforts in the field of ICI response biomarkers in NSCLC patients and highlights advantages and limitations as we discuss the road to clinical implementation.

Predictive role of HER-2/neu overexpression and clinical features at initial presentation in patients with extensive stage small cell lung carcinoma

Lung Cancer ◽  
2002 ◽  
Vol 36 (3) ◽  
pp. 257-261 ◽  
Author(s):  
Anil Potti ◽  
James Willardson ◽  
Caralee Forseen ◽  
Apar Kishor Ganti ◽  
Michael Koch ◽  
...  
Keyword(s):  
Clinical Features ◽  
Lung Carcinoma ◽  
Small Cell Lung Carcinoma ◽  
Small Cell ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma ◽  
Extensive Stage ◽  
Predictive Role ◽  
Her 2
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