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[A Case Report of Checkpoint Inhibitor Pneumonitis Caused by PD-1
Antibody-Safety and Effectiveness of Pirfenidone].
Yu, Haiming; Li, Jinying; Yu, Lan; Cheng, Xi; Han, Xiaona; Zhang, Xiaotao.
  • Yu H; Department of Stereotactic Radiotherapy, Qingdao Central Hospital, Qingdao 266042, China.
  • Li J; Department of Stereotactic Radiotherapy, Qingdao Central Hospital, Qingdao 266042, China.
  • Yu L; Department of Stereotactic Radiotherapy, Qingdao Central Hospital, Qingdao 266042, China.
  • Cheng X; Department of Stereotactic Radiotherapy, Qingdao Central Hospital, Qingdao 266042, China.
  • Han X; Department of Stereotactic Radiotherapy, Qingdao Central Hospital, Qingdao 266042, China.
  • Zhang X; Department of Stereotactic Radiotherapy, Qingdao Central Hospital, Qingdao 266042, China.
Zhongguo Fei Ai Za Zhi ; 24(7): 519-525, 2021 Jul 20.
Article in Chinese | MEDLINE | ID: covidwho-1348716
ABSTRACT

BACKGROUND:

Immune checkpoint inhibitor associated pneumonia (CIP) is a serious side effect of immune checkpoint inhibitors. There is a consensus on the treatment of acute phase of CIP, but the treatment of pulmonary interstitial fibrosis after the acute phase is still a clinical problem to be solved.

METHODS:

The diagnosis and treatment of a non-small cell lung cancer (NSCLC) patient with immune checkpoint inhibitor associated pneumonia in the Stereotactic Radiotherapy Department of Qingdao Central Hospital were retrospectively analyzed, and literatures were reviewed.

RESULTS:

A 70-year-old male patient was diagnosed with Poorly differentiated squamous cell carcinoma of left lung with mediastinal lymph node metastasis T3N3M0 stage IIIc, EGFR/ALK/ROS1/RAF negative, PD-L1 (22c3) immunohistochemistry negative. After the progression of first-line chemotherapy, the patient was diagnosed as immune checkpoint inhibitor associated pneumonia grade 3 during second-line monotherapy with Nivolumab. After initial high-dose glucocorticoid pulse therapy, the lung computed tomography (CT) imaging and clinical symptoms of the patients were partially relieved, and then pirfenidone (300 mg tid) was given orally for more than 11 months. During the treatment of pirfenidone, the CT imaging and clinical symptoms of the patients were significantly improved, and there were no other adverse reactions except grade 1 nausea. During this period, chemotherapy and Anlotinib was given concurrently with pirfenidone and showed good safety profile.

CONCLUSIONS:

This case report is the first report of pirfenidone in the treatment of CIP, which provides a new idea for the clinical practice and research of CIP treatment.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia / Pyridones / Carcinoma, Squamous Cell / Anti-Inflammatory Agents, Non-Steroidal / Immune Checkpoint Inhibitors / Lung Neoplasms Type of study: Case report / Experimental Studies / Observational study / Prognostic study Limits: Aged / Humans / Male Language: Chinese Journal: Zhongguo Fei Ai Za Zhi Journal subject: Neoplasms Year: 2021 Document Type: Article Affiliation country: J.issn.1009-3419.2021.103.08

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia / Pyridones / Carcinoma, Squamous Cell / Anti-Inflammatory Agents, Non-Steroidal / Immune Checkpoint Inhibitors / Lung Neoplasms Type of study: Case report / Experimental Studies / Observational study / Prognostic study Limits: Aged / Humans / Male Language: Chinese Journal: Zhongguo Fei Ai Za Zhi Journal subject: Neoplasms Year: 2021 Document Type: Article Affiliation country: J.issn.1009-3419.2021.103.08